Department of Orthopedic Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan; Department of Rehabilitation, Osaka International Cancer Institute, Osaka 541-8567, Japan.
Department of Orthopedic Surgery, Osaka International Cancer Institute, Osaka 541-8567, Japan.
J Geriatr Oncol. 2022 Jun;13(5):673-681. doi: 10.1016/j.jgo.2022.02.011. Epub 2022 Feb 24.
Surgery, chemotherapy, and radiotherapy are the treatments for soft tissue sarcoma (STS) similar to those for other cancers. However, treatment is even more difficult in older patients because of aging-related weakness. The influence of aging-associated factors on prognosis in the patients with STS has not been fully elucidated. This study aimed to clarify the factors that impact prognosis in older patients with STS.
The present study retrospectively analyzed the data of 262 (≥60 years old) patients with STS. Moreover, this study investigated (1) tumor-associated parameters (e.g., tumor site, tumor size, depth, histological grade [Federation Nationale des Centres de Lutte le Cancer], American Joint Committee on Cancer [AJCC, eighth edition] stage, and histotype); (2) treatment-related factors (i.e., presence of surgery, neoadjuvant/adjuvant chemotherapy, adjuvant radiotherapy, and surgical margin); and (3) patient-dependent counterparts (e.g., age, gender, performance status [PS], body mass index [BMI], and Charlson comorbidity index [CCI]). Statistical analysis was conducted to evaluate the impact of each factor on overall survival (OS).
Among the 262 patients, 217 and 45 were 60-79 and ≥80 years old, respectively. A comparison of the sociodemographic background showed no significant difference other than surgical margin and PS between those groups. According to univariate analysis, the significant factors to impact OS were age, stage, tumor size, depth, surgical margin, PS, BMI, and CCI. Multivariate analysis indicated that advanced stage, poor PS, and low BMI were negative prognostic factors for OS. Intriguingly, multivariate analysis demonstrated that CCI was a not significant factor for OS in this study.
While AJCC stage is a well-known determinant, this study suggests that physicians should be alerted to poor PS and low BMI in older patients with STS.
手术、化疗和放疗是治疗软组织肉瘤（STS）的方法，与其他癌症类似。然而，由于与衰老相关的虚弱，老年患者的治疗更加困难。衰老相关因素对 STS 患者预后的影响尚未完全阐明。本研究旨在阐明影响老年 STS 患者预后的因素。
本研究回顾性分析了 262 例（≥60 岁）STS 患者的数据。此外，本研究还研究了（1）与肿瘤相关的参数（例如肿瘤部位、肿瘤大小、深度、组织学分级[法国国家癌症中心]、美国癌症联合委员会[AJCC，第 8 版]分期和组织类型）；（2）治疗相关因素（即是否存在手术、新辅助/辅助化疗、辅助放疗和手术切缘）；（3）患者相关因素（如年龄、性别、表现状态[PS]、体重指数[BMI]和 Charlson 合并症指数[CCI]）。进行统计学分析以评估每个因素对总生存期（OS）的影响。
在 262 例患者中，217 例患者为 60-79 岁，45 例患者≥80 岁。两组患者的社会人口统计学背景比较除手术切缘和 PS 外无显著差异。根据单因素分析，对 OS 有显著影响的因素有年龄、分期、肿瘤大小、深度、手术切缘、PS、BMI 和 CCI。多因素分析表明，晚期、PS 差和 BMI 低是 OS 的不良预后因素。有趣的是，多因素分析表明 CCI 不是本研究中 OS 的显著因素。
尽管 AJCC 分期是一个众所周知的决定因素，但本研究表明，医生应该警惕老年 STS 患者 PS 差和 BMI 低的情况。
