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Worse Survival in Elderly Patients with Extremity Soft-Tissue Sarcoma
Miriam L Hoven-Gondrie1, Esther Bastiaannet2,3, Vincent K Y Ho4
1Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. m.hoven@telfort.nl.
Annals of Surgical Oncology
|March 10, 2016
Summary
Elderly patients over 65 with extremity soft-tissue sarcoma (ESTS) present with different tumor types and receive less aggressive treatment, leading to significantly worse survival rates compared to younger patients.
Area of Science:
- Oncology
- Geriatric Medicine
- Surgical Oncology
Background:
- Soft-tissue sarcoma (STS) disproportionately affects individuals over 65.
- The clinical behavior and outcomes of STS in elderly patients remain poorly understood.
- Extremity STS (ESTS) is a significant concern in the aging population.
Purpose of the Study:
- To evaluate the impact of age on survival outcomes in extremity soft-tissue sarcoma (ESTS) patients.
- To analyze how histotype, grade, stage, and treatment influence survival in elderly ESTS patients.
- To compare survival rates between younger (<65 years) and older (>65 years) ESTS patients.
Main Methods:
- Retrospective analysis of 3066 ESTS patients diagnosed between 1989-2008 from the Netherlands Cancer Registry.
- Comparison of patient and treatment characteristics between younger and elderly cohorts.
- Estimation of relative survival and relative excess risk of death based on age groups.
Main Results:
- Elderly patients exhibited distinct sarcoma histotypes compared to younger individuals (p < 0.001).
- Older patients were more frequently diagnosed with high-stage and high-grade ESTS (p < 0.001).
- A higher proportion of elderly patients received no treatment, and fewer received combined-modality treatment, correlating with significantly worse 5-year relative survival (43.8% vs 72.7%).
Conclusions:
- Age is a significant independent prognostic factor for ESTS survival.
- The distinct tumor characteristics, less aggressive treatment, and poorer outcomes in the elderly highlight the need for tailored research and care strategies.
- Optimizing sarcoma research and geriatric care is crucial for improving survival in elderly ESTS patients.
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