Surgical Management of Malignant Soft Tissue Tumours in Patients Aged 65 Years or Older

Abstract

For geriatric patients, wide surgical margins are required to manage both low- and high-grade neoplasms, in order to avoid multiple surgeries.

Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors

“…The majority of orthopedic oncologists are likely to select less invasive or conservative treatments for elderly patients, especially for those with poor performance status (8)(9)(10)(11)(12)(13). However, due to recent developments in multimodal medical technologies, including diagnostic modalities, chemotherapy, anesthesia and surgical methods, more elderly patients may be able to undergo surgery with a reduced risk than has previously been the case (8)(9)(10)(11)(12)(13).…”

“…However, due to recent developments in multimodal medical technologies, including diagnostic modalities, chemotherapy, anesthesia and surgical methods, more elderly patients may be able to undergo surgery with a reduced risk than has previously been the case (8)(9)(10)(11)(12)(13). There have been few previous studies concerning elderly patients with primary malignant bone and soft tissue tumors (8)(9)(10)(11)(12)(13). The aim of the present study was to retrospectively analyze the clinical outcomes of elderly patients diagnosed with these tumors and to determine any potential prognostic factors.…”

“…Aging has been reported to be an indicator of poor prognosis in the treatment of bone and soft tissue tumors (6)(7)(8); in general, this was thought to be due to reduced physiologic function and a decreased general tolerance to cancer treatment in elderly patients. The majority of orthopedic oncologists are likely to select less invasive or conservative treatments for elderly patients, especially for those with poor performance status (8)(9)(10)(11)(12)(13).…”

What Is the Effect of Advanced Age and Comorbidity on Postoperative Morbidity and Mortality After Musculoskeletal Tumor Surgery?

“…According to data from the nationwide bone and soft tissue tumor registry in Japan, more than 80% of patients with primary musculoskeletal tumors underwent surgery at university hospitals or cancer treatment centers contributing to the Diagnosis Procedure Combination system because of the rarity of the disease and the specialized surgical procedures required. Several investigators have reported the clinical outcomes of elderly patients with musculoskeletal sarcomas along with the demographic changes (aging) and the development of perioperative management [1,2,4,9,15]. However, these reports mainly highlighted the long-term outcome such as metastasis, local recurrence, or tumorrelated death, and little information is available regarding short-term surgical outcomes such as morbidity and mortality [2,4,9].…”

“…However, little information is available regarding the therapeutic outcomes in elderly patients with musculoskeletal sarcomas, and some studies have relatively small cohorts [1,2,4,9,15]. These studies mainly highlighted the long-term outcome with an endpoint of tumor-related death, local recurrence, or metastasis [1,2,4,9,15], and little information is available regarding the effect of advanced age or comorbidity on the short-term outcomes. Perioperative mortality and morbidity have not been well documented.…”