Escobar-Mendiola Daniel, Mediavilla-Santos Lydia, Pérez-Mañanes Rubén, Cuervo-Dehesa Miguel, Vaquero-Martin Javier, Calvo-Haro José
Servicio de Cirugía Ortopédica Y Traumatología, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain.
Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón Y Cajal, s/n, 28040 Madrid, Spain.
Indian J Surg Oncol. 2024 Mar;15(Suppl 1):11-18. doi: 10.1007/s13193-022-01652-1. Epub 2022 Sep 27.
The number of elderly patients diagnosed with cancer is increasing. However, knowledge regarding cancer in elderly patients is very scarce. The aim of this study is to analyze the differences in management and outcomes of high-grade extremity sarcomas between elderly and middle-aged patients. Two cohorts were made (> 70 and 30/50 years old) among patients treated in a multidisciplinary unit of a national reference center between 2011 and 2017 with a minimum of 2 years of follow-up. The management and outcomes between these two cohorts were compared. Seventy patients were included, 34 young patients and 36 elderly patients. The only difference between the treatment schemes was the chemotherapy used, 67.6% of the young patients received chemotherapy versus 16.7% of the elderly patients ( = 0.000015). There were no differences either in the overall survival or the progression-free survival between groups at 1 and 2-year follow-up. Deceases for other causes were nearly exclusive of elderly patients at a median of 45.57 months. Surgery is the treatment of choice for sarcomas in both elderly and young patients having similar results in terms of progression-free survival, overall survival, and surgery outcomes. The use of chemotherapy is the only difference in the treatment schemes between both groups. In the elderly patient with minimal or no comorbidity and good functional reserve, surgical curative treatment should be chosen. As for frail elderly patients, the therapeutic objectives must be focused mainly on quality of life and palliation of symptoms.
被诊断出患有癌症的老年患者数量正在增加。然而，关于老年患者癌症的知识却非常匮乏。本研究的目的是分析老年患者与中年患者在高级别肢体肉瘤的治疗管理和治疗结果上的差异。在2011年至2017年期间，于一家国家参考中心的多学科治疗科室接受治疗且随访至少2年的患者中，划分出了两个队列（年龄大于70岁以及30/50岁）。对这两个队列的治疗管理和治疗结果进行了比较。共纳入70例患者，34例年轻患者和36例老年患者。治疗方案之间的唯一差异在于所使用的化疗，67.6%的年轻患者接受了化疗，而老年患者中这一比例为16.7%（P = 0.000015）。在1年和2年随访时，两组之间的总生存期和无进展生存期均无差异。因其他原因死亡的情况几乎仅见于老年患者，中位时间为45.57个月。对于老年和年轻患者，手术都是肉瘤的首选治疗方法，在无进展生存期、总生存期和手术结果方面具有相似的结果。两组治疗方案的唯一差异在于化疗的使用。对于合并症极少或无合并症且功能储备良好的老年患者，应选择手术根治性治疗。至于身体虚弱的老年患者，治疗目标必须主要集中在生活质量和症状缓解上。
