Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Cyuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Int J Clin Oncol. 2018 Aug;23(4):775-782. doi: 10.1007/s10147-018-1255-x. Epub 2018 Feb 27.
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.
软组织肉瘤（STS）主要发生在中老年人中。虽然有报道称老年患者的预后较差，但很少有研究检查过晚期高龄患者。我们评估了晚期高龄 STS 患者的临床特征。
本回顾性研究纳入了 144 例患者，并根据 85 岁的截止年龄将他们分为两组（老年组和年轻组）。收集了患者的信息，包括年龄、肿瘤类型、位置、大小、转移情况、AJCC 分期、FNCLCC 分级、治疗相关因素、局部和远处复发以及结果。比较了两组患者的临床病程。
在所有患者中，老年组化疗的频率明显低于年轻组（P<0.01），老年组的随访时间明显短于年轻组（P<0.01）。老年组更频繁地拒绝手术治疗（P=0.01）。老年组的预后明显较差（P<0.05）。然而，在表现为局部疾病且接受手术治疗的患者中，两组之间的预后无显著差异。只有手术治疗影响老年患者的预后（P<0.01）。
尽管晚期高龄 STS 患者的预后一般较差，但接受手术治疗的 STS 患者的预后并不差。只有手术治疗干预强烈影响预后，因此积极的手术治疗可能改善预后。
