Department of Academic Surgery, Sarcoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London, UK.
Department of Sarcoma and General Surgery, Midlands Abdominal and Retroperitoneal Sarcoma Unit, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TH, UK.
Ann Surg Oncol. 2022 Nov;29(12):7320-7330. doi: 10.1245/s10434-022-12231-7. Epub 2022 Jul 19.
As the population ages, more elderly patients are receiving surgery for retroperitoneal sarcoma (RPS). However, high-quality data investigating associations between ageing and prognosis are lacking. Our study aimed to investigate whether ageing is associated with inferior short-term survival outcomes after RPS surgery.
Patients undergoing surgery for primary RPS between 2008 and 2019 at two tertiary sarcoma centres were analysed. The primary outcome was 1-year mortality, and the primary explanatory variable was patient age, classified as: < 55, 55-64, 65-74 or 75+ years.
The 692 patients undergoing surgery (mean age 60.8 ± 13.8 years) had a 1-year mortality rate of 9.4%, which differed significantly by age (p < 0.001), with rates of 7.2%, 6.9%, 8.7% and 22.8% for the < 55, 55-64, 65-74 and 75+ years groups, respectively. The distribution of causes of death also differed significantly by age (p = 0.023), with 22% and 28% of deaths in the 65-74 and 75+ years groups caused by post-operative complications, versus none in the < 55 and 55-64 years groups. On multivariable analysis, age of 75+ years (versus < 55 years) was a significant independent predictor of 1-year mortality [odds ratio (OR) 7.05, 95% confidence interval (CI) 2.63-18.9, p < 0.001]; no significant increase in risk was observed in the 55-64 (OR 0.72, 95% CI 0.28-1.87) or 65-74 (OR 0.89, 95% CI 0.37-2.15) years groups.
Post-operative complications are an important cause of deaths in elderly patients. These findings are relevant to decision-making and counselling when surgery is considered for patients with RPS.
随着人口老龄化，越来越多的老年患者接受腹膜后肉瘤（RPS）手术。然而，缺乏关于年龄与预后之间关联的高质量数据。本研究旨在探讨 RPS 手术后年龄是否与短期预后不良相关。
分析了 2008 年至 2019 年间在两个三级肉瘤中心接受原发性 RPS 手术的患者。主要结局是 1 年死亡率，主要解释变量是患者年龄，分为：<55 岁、55-64 岁、65-74 岁和 75 岁以上。
692 例接受手术的患者（平均年龄 60.8 ± 13.8 岁）1 年死亡率为 9.4%，年龄差异有统计学意义（p < 0.001），<55 岁、55-64 岁、65-74 岁和 75 岁以上组的死亡率分别为 7.2%、6.9%、8.7%和 22.8%。死亡原因的分布也随年龄显著不同（p = 0.023），65-74 岁和 75 岁以上组 22%和 28%的死亡归因于术后并发症，<55 岁和 55-64 岁组无死亡归因于术后并发症。多变量分析显示，75 岁以上（与<55 岁）年龄是 1 年死亡率的独立显著预测因素[比值比（OR）7.05，95%置信区间（CI）2.63-18.9，p < 0.001]；55-64 岁（OR 0.72，95%CI 0.28-1.87）或 65-74 岁（OR 0.89，95%CI 0.37-2.15）组的风险未见显著增加。
术后并发症是老年患者死亡的一个重要原因。这些发现与考虑为 RPS 患者手术时的决策和咨询相关。
