Impact of geriatric factors on surgical and prognostic outcomes in elderly patients with soft-tissue sarcoma

<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">Objective</div>Patients aged ≥65 years requiring surgery for soft-tissue sarcoma are a concern in an aging society. We aimed to reveal the association of clinical/geriatric factors with survival period or postoperative events in such patients who underwent surgery.<div class="boxTitle">Methods</div>We enrolled patients aged ≥65 years who underwent surgery for localized soft-tissue sarcoma at five institutions. We retrospectively collected clinical/geriatric factors and laboratory data, and analyzed their association with outcomes using univariate and multivariate analyses.<div class="boxTitle">Results</div>Among the 202 patients included, mean age at presentation was 73 years. Surgical margin was R0 in 139 patients (69%). The Eastern Cooperative Oncology Group performance status was ≥2 in 15 (7%). Thirty patients (15%) showed thinness (body mass index <18.49 kg/cm²). High-sensitivity–modified Glasgow prognostic score ≥1 was seen in 52 patients (26%). Multivariate analysis showed that R1 surgical margin was significantly correlated with poor sarcoma-specific survival (hazard ratio for R1 <span style="font-style:italic;">vs.</span> R0, 3.17; <span style="font-style:italic;">P</span> = 0.001) and event-free survival (hazard ratio for R1 <span style="font-style:italic;">vs.</span> R0, 2.56; <span style="font-style:italic;">P</span> < 0.001). Higher Eastern Cooperative Oncology Group performance status was significantly associated with poor sarcoma-specific survival (hazard ratio for ≥2 <span style="font-style:italic;">vs.</span> 0 or 1, 2.15; <span style="font-style:italic;">P</span> = 0.038), and higher sensitivity-modified Glasgow prognostic score was significantly associated with poor event-free survival (hazard ratio for ≥1 <span style="font-style:italic;">vs.</span> 0, 1.74; <span style="font-style:italic;">P</span> = 0.046). Severe thinness (body mass index <16.00) was a risk factor for postoperative events (odds ratio for body mass index <16.00 <span style="font-style:italic;">vs.</span> ≥16.00, 8.15, <span style="font-style:italic;">P</span> = 0.010).<div class="boxTitle">Conclusions</div>Negative surgical margin was associated with better survival. Coexisting conditions had an impact on outcomes in elderly soft-tissue sarcoma patients.</span>

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