Department of Pediatrics, Maine Medical Center, Portland, ME.
Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX.
J Clin Oncol. 2024 Feb 20;42(6):675-685. doi: 10.1200/JCO.23.01275. Epub 2023 Nov 15.
Soft tissue sarcomas (STS) represent a heterogeneous group of extraskeletal mesenchymal tumors that affect individuals throughout the entire age continuum. Despite this pervasive influence, key differences exist in the presentation of these sarcomas across varying age groups that have prevented a more uniform approach to management. Notably, rhabdomyosarcoma (RMS) is more common in children, while most nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) subtypes are more prevalent in adults. Older patients with NRSTS appear to have more molecularly complex biology and often present with more advanced disease compared with children. Poorer outcome disparities are observed in older patients with RMS despite receiving similar treatment as younger patients. In this review, we highlight differences in epidemiology, biology, and management paradigms for pediatric and adult patients with STS and explore opportunities for a unified approach to enhance the care and outcomes within the AYA population.
软组织肉瘤（STS）是一组异质性的骨骼外间叶肿瘤，可影响整个年龄范围的个体。尽管有这种普遍的影响，但在不同年龄组中，这些肉瘤的表现存在显著差异，这阻碍了更统一的管理方法的建立。值得注意的是，横纹肌肉瘤（RMS）在儿童中更为常见，而大多数非横纹肌肉瘤软组织肉瘤（NRSTS）亚型在成人中更为普遍。与儿童相比，NRSTS 老年患者的生物学特性往往更为复杂，且常伴有更晚期的疾病。尽管 RMS 老年患者接受与年轻患者相似的治疗，但预后较差的差异仍存在。在这篇综述中，我们强调了儿科和成人 STS 患者在流行病学、生物学和管理模式方面的差异，并探讨了采用统一方法的机会，以提高 AYA 人群的治疗效果。
