Key result
Patients over 90 with soft tissue sarcomas had worse overall survival when not operated compared to younger patients (9.9 vs 27.3 months, P<0.001), despite comparable relapse-free survival.
Why the study?
Do patients over 90 with soft tissue sarcomas have different clinicopathological features and survival outcomes compared to younger patients?
Cohort
Yes
Do patients over 90 with soft tissue sarcomas have different clinicopathological features and survival outcomes compared to younger patients?
Patients over 90 with soft tissue sarcomas have distinct clinicopathological features but comparable relapse-free survival to younger patients, suggesting standard management should be proposed if oncogeriatric status allows.
Answers are grounded in this paper and cite their sources.
Characterizes STS presentation and outcomes in nonagenarians from a national registry; leaves open optimal management in this underrepresented group.
Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinicopathological presentation, and outcome of sarcoma patients over 90 recorded in the Netsarc.org French national database. NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow-up are collected in a database Information of patients registered from January 1, 2010, to December 31, 2016, in NETSARC were collected, analyzed and compared to the younger population. Patients with sarcomas aged >90 have almost exclusively sarcomas with complex genomics (92.0% vs. 66.3%), are less frequently metastatic (5.3% vs. 14·7%) at diagnosis, have more often superficial tumors (39.8% vs. 14.7%), as well as limbs and head and neck sites (75.2% vs. 38.7%) (all p < 0.001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p < 0.001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80-90. However, local relapse-free survival, metastatic relapse-free survival and relapse-free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p < 0.001). Patients over 90 who were not operated had worse overall survival than younger patients (9.9 vs. 27.3 months, p < 0.001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse-free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows.
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Basse et al. (2019) conducted a cohort in Soft tissue sarcomas. Age > 90 years vs. Younger patients was evaluated on Overall survival in not operated patients (months) (p=<0.001). Patients over 90 with soft tissue sarcomas had worse overall survival when not operated compared to younger patients (9.9 vs 27.3 months, P<0.001), despite comparable relapse-free survival.
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