Clinical outcomes of patients with primary malignant bone and soft tissue tumor aged 65 years or older

Hashimoto,Kazuhiko; Nishimura,Shunji; Hara,Yukiko; Oka,Naohiro; Tanaka,Hiroki; Iemura,Shunki; Akagi,Masao

doi:10.3892/etm.2018.7013

January-2019 Volume 17 Issue 1

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January-2019 Volume 17 Issue 1

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Article

Clinical outcomes of patients with primary malignant bone and soft tissue tumor aged 65 years or older

Authors:
- Kazuhiko Hashimoto
- Shunji Nishimura
- Yukiko Hara
- Naohiro Oka
- Hiroki Tanaka
- Shunki Iemura
- Masao Akagi
View Affiliations / Copyright

Affiliations: Department of Orthopedic Surgery, Kindai University Hospital, Osaka‑Sayama, Osaka 589‑8511, Japan
Pages: 888-894
|
Published online on: November 26, 2018

https://doi.org/10.3892/etm.2018.7013
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Abstract

The number of elderly patients with sarcoma (65 years or older) has increased with the rise in the aging of society. As it is difficult to treat elderly sarcoma patients in the same manner as younger patients, the present study sought to compare treatment options currently available for elderly patients. The present study was comprised 34 Japanese patients (21 men and 13 women) with malignant bone or soft tissue tumors who underwent surgery in our department from September 2004 to March 2014. The median patient age was 72 years (range, 65‑86 years). Histologically, 23 cases were categorized as high‑grade and 11 as low‑grade. Treatments included surgery with adequate margins (25 cases), surgery with inadequate margins and radiotherapy (4 cases), surgery with inadequate margins and chemotherapy (3 cases) and intralesional resection (2 cases). The postoperative follow‑up period ranged from 7 to 112 months (average, 49 months). The 5‑year survival rates were determined and compared using the Kaplan‑Meier method and log‑rank test, respectively. Eastern Cooperative Oncology Group Performance Status (ECOG‑PS) and Anesthesiologists‑Physical Status (ASA‑PS) scores were also determined. The overall 5‑year survival rate was 86.02%; it differed significantly between patients with high‑grade (100%) vs. low‑grade (74.3%) neoplasms P<0.001), but not between patients aged 65‑69 (76.9%) vs. ≥70 (90.2%) years‑old (P=0.65). Tumor status was classified as follows: i) Continuously disease‑free, n=24 cases; ii) alive with disease, n=3 cases; iii) and dead of disease, n=7 cases. The ECOG‑PS status scores were 0 in 9 cases, 1 in 21 cases, and 2 in 4 cases. ASA‑PS scores were also I in 9 cases and II in 23 cases. Thus, the primary treatment for elderly patients with sarcoma should be surgery alone as no additional benefits were obtained when radiotherapy or chemotherapy was also performed. Adequate margins should be confirmed along with the histology of surgical specimens.

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