The prognostic significance of surgical treatment for excessive elderly patients with soft tissue sarcoma

Soft tissue sarcoma (STS) mainly occurs in middle-aged and senior citizens. Although a poorer prognosis has been reported for older patients, few studies have examined advanced elderly excessive older patients. We evaluated the clinical features of advanced elderly patients with STS.

One hundred and forty-four patients were included in this retrospective study, and we divided them into two groups based on a cut-off age of 85 (older and younger groups). The patients' information, including age, tumor type, location, size, presence of metastasis, AJCC stage, FNCLCC classification, treatment-related factors, local and distant relapse, and outcome, was collected. We compared the clinical courses between the 2 groups.

In all patients, the frequency of chemotherapy in the older group was significantly lower than in the younger group (P < 0.01), and the follow-up period in the older group was significantly shorter than in the younger group (P < 0.01). Surgical treatment was refused more frequently in the older group (P = 0.01). The older group showed a significantly poorer prognosis (P < 0.05). However, in patients with localized disease at presentation treated with surgery, there was no significant difference in prognosis between the 2 groups. Only surgical treatment affected the prognosis in older patients (P < 0.01).

Although the prognosis of advanced elderly STS patients is generally poor, that of STS patients with surgical treatment is not poor. Only surgical treatment intervention strongly influences the prognosis, and so the prognosis may be improved with aggressive surgical treatment.