Surgical Treatment and Prognosis of Soft Tissue Sarcoma in Patients Aged 85 Years and Older.

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.

Patients and methods: 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.

Results: 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 (p=0.0476) and ≥90 years (p=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 (p =0.0300).

Conclusion: Surgical treatment improves the prognosis in elderly STS patients aged ≥85 years and possibly among those aged ≥90 years.