Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
Clin Oncol (R Coll Radiol). 2023 Apr;35(4):269-277. doi: 10.1016/j.clon.2023.01.002. Epub 2023 Jan 13.
As the US population continues to age, oncological strategies and outcomes for soft tissue sarcomas (STSs) should continue to be examined for varying age groups. The aim of this study was analyse and compare treatment strategies and oncological outcomes for octogenarian patients with STSs.
Data from the Surveillance, Epidemiology and End Results (SEER) national database were used. Varying treatment modalities were studied when utilised for specific tumour staging with respect to the eighth edition of the American Joint Committee on Cancer.
In total, 24 666 patients were included for analysis, where 3341 (14%) were 80 years old or older. The octogenarian group was diagnosed with more advanced disease (stages II-IV), relative to their younger counterparts (85% versus 75%, P < 0.001). However, a smaller proportion of the older patients underwent surgical resection (74% versus 86%, P < 0.001). Likewise, the octogenarians received less chemotherapy (4% versus 21%, P < 0.001) and radiotherapy (29% versus 42%, P = 0.010). Surgical resection and chemotherapy significantly improved overall survival for those older patients with stage II STS, whereas surgical resection and radiotherapy improved mortality in this cohort with both stage III and IV STS. Overall survival at 1 and 5 years of follow-up was lower within the octogenarian group compared with the younger group (1 year: 68% versus 88%, P < 0.001 and 5 years: 7% versus 58%, P < 0.001).
Octogenarian patients, in most cases, are diagnosed with stage III or metastatic disease. Surgical resection of the primary tumour was beneficial in both age cohorts, with radiotherapy correlating to better overall survival when used in those patients with higher stage STS. Chemotherapy was associated with better mortality in the younger cohort with respect to tumour stage. The octogenarian overall survival at 1 and 5 years was lower than for younger patients.
随着美国人口老龄化的持续，软组织肉瘤（STS）的肿瘤学策略和结果应继续针对不同年龄组进行检查。本研究的目的是分析和比较 80 岁及以上 STS 患者的治疗策略和肿瘤学结果。
使用来自监测、流行病学和最终结果（SEER）国家数据库的数据。根据第八版美国癌症联合委员会，针对特定肿瘤分期，研究了不同的治疗方式。
共有 24666 例患者纳入分析，其中 3341 例（14%）年龄在 80 岁或以上。与年轻患者相比，80 岁及以上患者的疾病诊断更为晚期（II-IV 期）（85%比 75%，P <0.001）。然而，接受手术切除的老年患者比例较小（74%比 86%，P <0.001）。同样，老年患者接受的化疗（4%比 21%，P <0.001）和放疗（29%比 42%，P =0.010）较少。对于 II 期 STS 患者，手术切除和化疗显著改善了总体生存率，而对于 III 期和 IV 期 STS 患者，手术切除和放疗改善了死亡率。与年轻组相比，80 岁及以上组的 1 年和 5 年随访的总生存率较低（1 年：68%比 88%，P <0.001；5 年：7%比 58%，P <0.001）。
80 岁及以上患者在大多数情况下被诊断为 III 期或转移性疾病。对于两个年龄组，原发性肿瘤的手术切除都有益，对于更高分期的 STS 患者，放疗与更好的总生存率相关。与肿瘤分期相比，化疗与年轻组的死亡率降低相关。80 岁及以上患者的 1 年和 5 年总生存率低于年轻患者。
