Favorable outcome after complete resection in elderly soft tissue sarcoma patients: Japanese Musculoskeletal Oncology Group study

Yoneda, Yasushi; Kunisada, Toshiyuki; Naka, Norifumi; Nishida, Yoshihiro; Kawai, Akira; Morii, Takeshi; Takeda, Kayo; Hasei, Joe; Yamakawa, Yukie; Ozaki, Toshifumi

doi:10.1016/j.ejso.2013.09.004

Cited by 23 publications

(19 citation statements)

References 23 publications

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“…Previous single‐institution studies have arrived at the conclusion that age in and of itself is not a contraindication to attempting potentially curative operations in elderly patients with cancer . Buchner et al performed a prospective study on 21 patients with STS over the age of 70.…”

Section: Discussionmentioning

confidence: 99%

Extremity soft tissue sarcoma in the elderly: Are we overtreating or undertreating this potentially vulnerable patient population?

Gingrich

Bateni

Monjazeb

et al. 2019

Journal of Surgical Oncology

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Background As the U.S. population ages, differences in oncologic outcomes among the elderly have been recognized. Our objective was to analyze the clinical, pathologic, and treatment outcomes for elderly soft tissue sarcoma (STS) patients, hypothesizing significant differences in the management and response to therapy. Methods Using the National Cancer Database, we identified 33 859 patients with nonmetastatic extremity STS. We defined elderly as ≥74 years in age and compared patient and treatment variables between adult and elderly patients. Cox‐proportional hazards analysis was used to determine predictors of overall survival (OS). Results We identified 8504 elderly patients. Significant differences in histologic subtype, grade, and facility type between elderly and nonelderly patients (P < 0.05) exist. Elderly patients were less likely to undergo R0 resection (P = 0.001) and had a higher 90‐day mortality (P = 0.001). Surgical elderly patients experienced superior OS compared with nonsurgical patients (P = 0.001). Among elderly patients, younger age, and female sex, lower Charlson‐Deyo score, lower grade, smaller tumors, surgical resection, negative surgical margins, and radiation therapy were associated with better OS. Conclusions Key differences exist in elderly extremity STS patients, including a narrower benefit/risk ratio with surgical management. These data highlight that elderly patients represent a distinct cohort for whom more careful selection appears indicated.

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Section: Discussionmentioning

confidence: 99%

Extremity soft tissue sarcoma in the elderly: Are we overtreating or undertreating this potentially vulnerable patient population?

Gingrich

Bateni

Monjazeb

et al. 2019

Journal of Surgical Oncology

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“…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). There have been few previous studies concerning elderly patients with primary malignant bone and soft tissue tumors (8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 93%

“…As shown in Table V, Lahat et al (9) reported a 5-year disease-specific survival of 63%, while Kozawa et al (12) reported that the 5-year overall survival was 72% in elderly patients with bone and soft tissue tumors. In addition, Yoneda et al (13) conducted a retrospective analysis involving 158 elderly patients with localized soft tissue sarcoma and found that the overall 5-year survival rate was 83%.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…At present, there are no established treatments for elderly sarcoma patients, who are difficult to treat in the same manner as their young counterparts because of potential immunodeficiencies, underlying diseases, complications, and social backgrounds. Moreover, studies addressing the management of elderly sarcoma patients are few (4)(5)(6)(7)(8)(9)(10), with controversial results. Here we present a retrospective study aimed at determining the best treatment strategy for elderly sarcoma patients.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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Favorable outcome after complete resection in elderly soft tissue sarcoma patients: Japanese Musculoskeletal Oncology Group study

Cited by 23 publications

References 23 publications

Extremity soft tissue sarcoma in the elderly: Are we overtreating or undertreating this potentially vulnerable patient population?

Extremity soft tissue sarcoma in the elderly: Are we overtreating or undertreating this potentially vulnerable patient population?

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

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

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