Clinical outcomes of patients with primary malignant bone and soft tissue tumor aged 65�years or older

Abstract

The number of elderly patients with sarcoma (65 years or older) has increased with the rise in the aging of society. As it is difficult to treat elderly sarcoma patients in the same manner as younger patients, the present study sought to compare treatment options currently available for elderly patients. The present study was comprised 34 Japanese patients (21 men and 13 women) with malignant bone or soft tissue tumors who underwent surgery in our department from September 2004 to March 2014. The median patient age was 72 years (range, 65-86 years). Histologically, 23 cases were categorized as high-grade and 11 as low-grade. Treatments included surgery with adequate margins (25 cases), surgery with inadequate margins and radiotherapy (4 cases), surgery with inadequate margins and chemotherapy (3 cases) and intralesional resection (2 cases). The postoperative follow-up period ranged from 7 to 112 months (average, 49 months). The 5-year survival rates were determined and compared using the Kaplan-Meier method and log-rank test, respectively. Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and Anesthesiologists-Physical Status (ASA-PS) scores were also determined. The overall 5-year survival rate was 86.02%; it differed significantly between patients with high-grade (100%) vs. low-grade (74.3%) neoplasms P<0.001), but not between patients aged 65-69 (76.9%) vs. ≥70 (90.2%) years-old (P=0.65). Tumor status was classified as follows: i) Continuously disease-free, n=24 cases; ii) alive with disease, n=3 cases; iii) and dead of disease, n=7 cases. The ECOG-PS status scores were 0 in 9 cases, 1 in 21 cases, and 2 in 4 cases. ASA-PS scores were also I in 9 cases and II in 23 cases. Thus, the primary treatment for elderly patients with sarcoma should be surgery alone as no additional benefits were obtained when radiotherapy or chemotherapy was also performed. Adequate margins should be confirmed along with the histology of surgical specimens.

Evaluation of immune‑biomarker expression in high‑grade soft‑tissue sarcoma: HLA‑DQA1 expression as a prognostic marker

“…The predictors of survival time in patients with high-grade STS include tumor size, histology, grading, margin status at resection and the presence of pre-surgical metastasis ( 5 ). It has been previously indicated that old age affects the prognosis of STS ( 15 ), but in the cohort of the present study, with an average age of 66.2 years (range, 39-86 years), the age difference between the two study groups was not statistically significant. The standard treatment of high-grade STS includes surgical resection, with radiation therapy as a supplementary treatment and chemotherapy added if required.…”

Surgical management of sarcoma in adolescent and young adult patients

“…Our previous study showed that the 5-year survival rate of elderly sarcoma patients was 86% [17]. In the current study, the 3-year survival rate was poorer (61.36%) than those previously reported [17] and that of elderly patients in our hospital. There was also no signi cant difference in survival rates based on age among these AYA patients.…”

Surgical management of sarcoma in adolescent and young adult patients

“…Our previous study showed that the 5-year survival rate of elderly sarcoma patients was 86% [18]. In the current study, the 3-year survival rate was poorer (61.36%) than those previously reported [18] and that of elderly patients in our hospital. There was also no significant difference in survival rates based on age among these AYA patients.…”

“…The 5-year survival rate in AYA sarcoma patients is approximately 70% [10,17], although prognoses in AYA patients may vary depending on age [17]. Our previous study showed that the 5-year survival rate of elderly sarcoma patients was 86% [18]. In the current study, the 3-year survival rate was poorer (61.36%) than those previously reported [18] and that of elderly patients in our hospital.…”