Tsuchie Hiroyuki, Emori Makoto, Murata Shohei, Murahashi Yasutaka, Mizushima Emi, Shimizu Junya, Nagasawa Hiroyuki, Teramoto Atsushi, Miyakoshi Naohisa
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan;
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
In Vivo. 2025 May-Jun;39(3):1661-1668. doi: 10.21873/invivo.13967.
BACKGROUND/AIM: The incidence of soft tissue sarcomas (STSs) among older patients is increasing. Although it has been reported that surgical treatment of elderly patients with STS improves prognosis, most of these studies included patients aged <85 years. This study aimed to analyze the clinical features and prognostic factors of STS in excessively elderly patients aged ≥85 or ≥90 years.
We retrospectively identified 398 patients with STS who were treated at our two hospitals between 1994 and 2022. Only histological types that existed in ≥20 cases were included. Data on clinical information and detailed assessments were collected. We divided the patients into two subgroups according to 85 or 90 years of age and compared the groups within each subgroup. Furthermore, we examined the factors affecting the prognosis of all and older patients.
Patients ≥85 or ≥90 years old comprised 12.1% and 4.0% of the study population, respectively. In all patients, Kaplan-Meier curves for overall survival demonstrated a significantly poorer prognosis in elderly patients with STS aged ≥85 years (=0.0476) and ≥90 years (=0.0164). However, no significant differences were observed when analyzing only patients who underwent surgical treatment without distant metastasis at diagnosis. In the multivariate analyses, surgical treatment for the primary tumor improved prognosis exclusively in patients ≥85 years old ( =0.0300).
Surgical treatment improves the prognosis in elderly STS patients aged ≥85 years and possibly among those aged ≥90 years.
背景/目的：老年患者软组织肉瘤（STS）的发病率正在上升。尽管有报道称，老年STS患者的手术治疗可改善预后，但这些研究大多纳入了年龄<85岁的患者。本研究旨在分析年龄≥85岁或≥90岁的高龄STS患者的临床特征和预后因素。
我们回顾性分析了1994年至2022年间在我们两家医院接受治疗的398例STS患者。仅纳入病例数≥20例的组织学类型。收集临床信息和详细评估数据。我们根据85岁或90岁将患者分为两个亚组，并比较每个亚组内的组间差异。此外，我们还研究了影响所有患者和老年患者预后的因素。
年龄≥85岁或≥90岁的患者分别占研究人群的12.1%和4.0%。在所有患者中，总体生存的Kaplan-Meier曲线显示，年龄≥85岁（=0.0476）和≥90岁（=0.0164）的老年STS患者预后明显较差。然而，在仅分析诊断时无远处转移且接受手术治疗的患者时，未观察到显著差异。在多因素分析中，仅年龄≥85岁的患者，原发肿瘤的手术治疗可改善预后（=0.0300）。
手术治疗可改善年龄≥85岁的老年STS患者的预后，可能也适用于年龄≥90岁的患者。
