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. 2020 Aug 4;9(8):2503.
doi: 10.3390/jcm9082503.

The Real-Life Journey of Elderly Patients in Soft Tissue and Bone Sarcomas: A Retrospective Analysis from a Sarcoma Referral Center

Virginia Ferraresi  1 , Sabrina Vari  1 , Barbara Rossi  2 , Gabriella Maggi  3 , Diana Giannarelli  4 , Agnese Persichetti  2 , Maria Grazia Petrongari  5 , Maria Cecilia Cercato  6 , Alessio Annovazzi  7 , Vincenzo Anelli  8 , Edoardo Pescarmona  9 , Jacopo Baldi  2 , Carmine Zoccali  2 , Domenicangela Pellegrini  1 , Francesco Cognetti  1 , Roberto Biagini  2
Affiliations

The Real-Life Journey of Elderly Patients in Soft Tissue and Bone Sarcomas: A Retrospective Analysis from a Sarcoma Referral Center

Virginia Ferraresi et al. J Clin Med. .

Abstract

The high complexity of multimodality treatment frequently results in undertreatment of elderly sarcoma patients, and this may be one of the factors that influence their prognosis. We describe the real-life approach to a population of patients aged over 70 with both soft tissue (STS) and bone sarcomas (BS) followed by our Sarcoma Disease Management Team from 2012 to 2017. One-hundred and twenty-three patients with a median age of 77 years (range: 70-92) were identified. STS were the most common histological subtypes (94%) and the grade was high in 79/123 patients (64%). At diagnosis, 88% of patients had localized disease (LD) and 12% were metastatic (MD). Overall, 96% of patients with LD underwent surgery, 46/54 (85%) with high grade STS patients underwent complementary radiotherapy, and 10/54 (19%) received adjuvant treatments. Twelve out of 33 patients who relapsed (36%) underwent local therapies. Seventeen (52%) and eight (24%) patients were treated with first-line and second-line medical treatments, respectively. Tolerability to systemic treatments was fairly good. Overall, 21% of the patients with advanced disease were candidates for best supportive care alone. Our case series of elderly patients with both STS and BS shows that personalized multidisciplinary treatment can nevertheless be offered to this frail population in order to control the evolution of disease.

Keywords: bone sarcomas; elderly patients; medical treatments; multidisciplinary treatment; radiotherapy; soft tissue sarcomas; surgery.

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Conflict of interest statement

V.F. declares personal fees and participation in conferences organized by Takeda Pharmaceutical and Eli Lilly and grants from PharmaMar. R.B. and V.A. declare participation in conferences organized by Takeda Pharmaceutical and grants from PharmaMar.

Figures

Figure 1
Figure 1
First-line (17 patients; * 1 patients) (a) and second-line (8 patients) (b) treatment.
Figure 2
Figure 2
Overall survival localized advanced disease (blue line) vs. metastatic disease (green line) (p < 0.0001).
Figure 3
Figure 3
Overall survival G1–G2 (blue line) vs. G3 histotypes (green line) (p = 0.05).
Figure 4
Figure 4
Overall survival patients aged ≥75 years (green line) vs. patients aged <75 years (blue line) (p = 0.39).
Figure 5
Figure 5
Quality-of-Life variables and trend over time.
Figure 6
Figure 6
Treatment algorithm of Istituti Fisioterapici Ospitalieri (IFO)-Sarcoma Disease Management Team (DMT). PS: Performance Status. * Depending on histotype, grade, site, and size, as per current guidelines.
See this image and copyright information in PMC

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