Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan.
Med Princ Pract. 2024;33(5):424-430. doi: 10.1159/000539728. Epub 2024 Jun 10.
The incidence of soft tissue sarcomas (STSs) among older patients is increasing. Although surgical treatment of elderly patients with STS has been reported to improve their prognosis, most of these studies included patients with STS aged <85 years. This study aimed to analyze the clinical features and prognostic factors of STS in elderly patients aged ≥90 years.
We retrospectively identified patients aged ≥90 years with STS who were treated at our two hospitals between 1994 and 2022. Data on clinical information and detailed assessments were collected. We evaluated the features and factors affecting the prognosis of patients with older-extremity STS. In addition, we compared the clinical courses and results of patients treated with surgery and radiotherapy for primary tumors.
Among 454 patients with STS, 16 were aged ≥90 years. Kaplan-Meier curves for overall survival showed a significantly poorer prognosis in patients who did not receive surgical treatment (p = 0.0348) and those who received radiotherapy (p = 0.0070). Moreover, we investigated the difference in prognosis between surgical treatment and radiotherapy, excluding two cases with distant metastasis at initial diagnosis and one case with no treatment. Kaplan-Meier curves for overall survival showed a significantly better prognosis in patients who underwent surgical treatment (p = 0.0161). Univariate analysis revealed that only primary tumor size was a significant predictor of poor prognosis (p = 0.0426).
In patients with STS aged ≥90 years old, aggressive surgical treatment may improve the prognosis more than radiotherapy.
老年人软组织肉瘤（STS）的发病率正在增加。尽管有研究报道手术治疗老年 STS 患者可以改善其预后，但这些研究大多纳入了年龄<85 岁的 STS 患者。本研究旨在分析年龄≥90 岁的 STS 患者的临床特征和预后因素。
我们回顾性地确定了 1994 年至 2022 年在我们两家医院治疗的年龄≥90 岁的 STS 患者。收集了临床信息和详细评估数据。我们评估了高龄肢体 STS 患者的特征和影响预后的因素。此外，我们比较了手术和放疗治疗原发性肿瘤的临床过程和结果。
在 454 名 STS 患者中，有 16 名年龄≥90 岁。总生存的 Kaplan-Meier 曲线显示，未接受手术治疗（p=0.0348）和接受放疗（p=0.0070）的患者预后明显较差。此外，我们排除了 2 例初诊时远处转移和 1 例未治疗的病例，研究了手术治疗和放疗之间的预后差异。总生存的 Kaplan-Meier 曲线显示，接受手术治疗的患者预后明显更好（p=0.0161）。单因素分析显示，只有原发肿瘤大小是预后不良的显著预测因素（p=0.0426）。
在年龄≥90 岁的 STS 患者中，积极的手术治疗可能比放疗更能改善预后。
