Complete soft tissue sarcoma resection is a viable treatment option for select elderly patients
Lahat G et al. - In a study to evaluate the outcome of elderly pts amenable to complete surgical resection treated at a single institution, it seems that properly selected elderly pts can safely undergo extensive soft tissue sarcoma (STS) resections. Until more effective therapies become available, surgery in the elderly is indicated and remains the best means for STS control. Methods- Prospectively accrued data were used to identify pts with primary STS age ≥65 yrs (n=325) who underwent complete macroscopic resection at 1 institution.
- Univariable and multivariable analyses were performed to identify prognostic factors.
Results- Median age at presentation was 72 yrs; 179 pts (55.1%) had associated comorbidities with an ASA score of ≥3.
- Extremity was the most common site (57.1%; n=186), undifferentiated pleomorphic sarcoma the most common histology (60.4%; n=197); 232 (71.2%) were high grade, 222 (68.3%) were >5 cm.
- 30-day postoperative mortality was 0.9% (n=3); overall complication rate was 30.7% (n=100), and mean postoperative hospital stay was 9 days.
- Estimated median survival was 96 mos, 5-yr disease-specific survival (DSS) was 63%.
- Multivariable analysis identified age ≥75 yrs, tumor size: 5–15 vs <5 cm, or >15 vs <5 cm, and high-grade as significant independent adverse prognostic factors.
- Compared with pts aged 65–74 yrs, older pts had more high-grade tumors, received chemotherapy less often, developed different patterns of recurrence, and exhibited a shorter median survival (70 mos).
[more...]
|
|
|
