PRIMARY SOFT TISSUE SARCOMA IN THE ELDERLY

Abstract

Purpose: To determine the outcome of patients 80 years old and greater that were diagnosed with a primary soft tissue sarcoma and if these patients should be treated as aggressively as younger patients.

Methods: One-hundred two patients were retrospectively reviewed.Well differentiated liposarcoma and der-matofibrosarcoma were excluded.

Results: There were 52 males. Average age was 84 years (80–94). Malignant fibrous histiocytoma was most common (36 patients) followed by leiomyosarcoma (22 pts) and liposarcoma (17 pts). Tumors were superficial in 25 patients and deep in 75. The lower extremity was most frequent site(70 patients), 27 patients had upper extremity involvement and 9 had a back lesion. MSTS stages were IA 6 patients, IB 22 patients, IIA 55 patients, IIB 9 patients, III 1 patient, and was unknown for 9 cases. Lesions were larger than 5cm in 80%. Four patients had no surgery, 89 patients had limb salvage, and 8 patients underwent amputation. Thirty-two patients had pre-operative radiotherapy, 30 patients had post-operative radiation, and 3 patients received both. No patients were given chemotherapy. The average follow up was 24 months (0–107months). Seventeen patients experienced local recurrence. Thirty-one patients developed metastatic disease. At latest follow-up 49 patients were alive without disease, 21 patients were alive with disease, 22 patients died of their disease, 8 patients died of another cause and the final status was unknown for 2 patients.. The MSTS functional score pre-treatment was 24 (11–72) and 31 (20–77) one year following treatment.

Conclusions: Elderly patients with soft tissue sarcoma have a poor outcome. Taking into account their associated medical condition, this group should likely be managed as younger patients although chemotherapy has no role according to our experience Funding: Other Education Grant Funding Parties: CIHR,|Stryker Canada