Sarcomas in patients over 90: Natural history and treatment-A nationwide study over 6 years.
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Databases, Factual
/ statistics & numerical data
Disease-Free Survival
Female
France
/ epidemiology
Humans
Infant
Infant, Newborn
Male
Middle Aged
Neoplasm Recurrence, Local
Registries
/ statistics & numerical data
Sarcoma
/ diagnosis
Soft Tissue Neoplasms
/ diagnosis
Young Adult
NETSARC
elderly patients
oncogeriatry
progression
registry
relapse
sarcomas
survival
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 10 2019
15 10 2019
Historique:
received:
19
10
2018
revised:
15
02
2019
accepted:
11
03
2019
pubmed:
30
3
2019
medline:
6
2
2020
entrez:
30
3
2019
Statut:
ppublish
Résumé
Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinicopathological presentation, and outcome of sarcoma patients over 90 recorded in the Netsarc.org French national database. NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow-up are collected in a database Information of patients registered from January 1, 2010, to December 31, 2016, in NETSARC were collected, analyzed and compared to the younger population. Patients with sarcomas aged >90 have almost exclusively sarcomas with complex genomics (92.0% vs. 66.3%), are less frequently metastatic (5.3% vs. 14·7%) at diagnosis, have more often superficial tumors (39.8% vs. 14.7%), as well as limbs and head and neck sites (75.2% vs. 38.7%) (all p < 0.001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p < 0.001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80-90. However, local relapse-free survival, metastatic relapse-free survival and relapse-free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p < 0.001). Patients over 90 who were not operated had worse overall survival than younger patients (9.9 vs. 27.3 months, p < 0.001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse-free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows.
Identifiants
pubmed: 30924137
doi: 10.1002/ijc.32307
pmc: PMC6767526
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2135-2143Informations de copyright
© 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
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