Premium
Sarcomas in patients over 90: Natural history and treatment—A nationwide study over 6 years
Author(s) -
Basse Clémence,
Italiano Antoine,
Penel Nicolas,
Mir Olivier,
Chemin Claire,
Toulmonde Maud,
Duffaud Florence,
Le Cesne Axel,
Chevreau Christine,
Maynou Carlos,
Anract Philippe,
Gouin François,
Rios Maria,
Firmin Nelly,
Kurtz JeanEmmanuel,
Kerbrat Pierre,
PipernoNeumann Sophie,
Bertucci François,
Rosset Philippe,
Isambert Nicolas,
Bompas Emmanuelle,
DubrayLongeras Pascale,
Fiorenza Fabrice,
Le Maignan Christine,
Chaigneau Loïc,
Thyss Antoine,
Bouché Olivier,
Eymard JeanChristophe,
Delcambre Lair Corinne,
Adam Julien,
Karanian Marie,
Lebbé Céleste,
Dupré Aurélien,
Meeus Pierre,
Brahmi Mehdi,
Dufresne Armelle,
Ducimetière Françoise,
RayCoquard Isabelle,
Blay JeanYves
Publication year - 2019
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.32307
Subject(s) - natural history , medicine , natural history study , pediatrics
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.