Ikuta Kunihiro, Sakai Tomohisa, Koike Hiroshi, Fujito Takeo, Urakawa Hiroshi, Nishida Yoshihiro, Imagama Shiro
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya 466-8550, Japan.
Rare Cancer Center, Nagoya University Hospital, 65 Tsurumai, Showa, Nagoya 466-8550, Japan.
Cancers (Basel). 2025 Jun 11;17(12):1940. doi: 10.3390/cancers17121940.
The management of soft tissue sarcoma in patients aged ≥ 85 years remains a clinical dilemma, as evidence to guide treatment decisions in this population is limited. Here, we aimed to compare the clinical characteristics of patients aged ≥ 85 years who underwent surgery with those who did not, to identify factors influencing surgical decision-making. We also assessed the oncological outcomes and postoperative complications in the patients.
We reviewed 37 consecutive patients with localized disease involving either the extremities or trunk wall, with a median age of 89.0 years. No significant differences in demographics or clinical characteristics were observed between patients who underwent surgery and those who received conservative management. Among the 37 patients, 25 underwent surgery with curative intent.
The two-year overall survival rate among surgically treated patients was 77%, with local recurrence-free survival and metastasis-free survival rates of 77% and 57%, respectively. Postoperative complications occurred in approximately one-third of the cases. Compared to those without complications, patients with complications were older ( = 0.025), had poorer performance status ( = 0.017), were likely to have trunk involvement ( = 0.01), and had larger tumor sizes ( = 0.025). No significant prognostic factors for overall survival were identified.
While surgery is not without risk, our results can provide useful information for both physicians and patients to discuss and explain possible outcomes with surgical treatment.
对于85岁及以上软组织肉瘤患者的管理仍然是一个临床难题，因为指导该人群治疗决策的证据有限。在此，我们旨在比较接受手术治疗的85岁及以上患者与未接受手术治疗患者的临床特征，以确定影响手术决策的因素。我们还评估了这些患者的肿瘤学结局和术后并发症。
我们回顾了37例连续的局限性疾病患者，病变累及四肢或胸壁，中位年龄为89.0岁。接受手术治疗的患者与接受保守治疗的患者在人口统计学或临床特征方面未观察到显著差异。在这37例患者中，25例接受了根治性手术。
接受手术治疗的患者两年总生存率为77%，局部无复发生存率和无转移生存率分别为77%和57%。约三分之一的病例发生了术后并发症。与无并发症的患者相比，有并发症的患者年龄更大（P = 0.025），体能状态更差（P = 0.017），更有可能累及胸壁（P = 0.01），肿瘤尺寸更大（P = 0.025）。未发现影响总生存的显著预后因素。
虽然手术并非没有风险，但我们的结果可为医生和患者讨论并解释手术治疗的可能结局提供有用信息。
