Abstract 1517P
Background
Incidence of soft tissue sarcomas (STS) increases with age. Older patients (pts) are underrepresented in clinical trials and guidelines are lacking. International oncological societies suggest using geriatric tools to evaluate older pts to optimize treatment. Comprehensive Geriatric Assessment (CGA) is a multidimensional assessment of elderly, based on which pts can be classified as fit, vulnerable or frail. OncoMPI is a CGA-based score which considers tumour characteristics, classifying pts in high-risk, intermediate-risk, low-risk group.
Methods
Consecutive pts with metastatic STS (mSTS) aged ≥70 years treated at Istituto Oncologico Veneto from January 2009 to June 2020 were retrieved from a prospectively maintained database. Pts demographics, CGA and tumor characteristics were analysed. Overall survival (OS) was calculated from diagnosis of metastatic disease to death. Kaplan-Meier curves and a Cox proportional hazards model were used for survival analyses.
Results
Out of 101 pts, 76 received chemotherapy (CHT) (75.3%), which was anthracycline-based for 46 pts (60.5%). Anthracyclines were used in a higher proportion in fit pts (58.9% fit Vs 45.1% vulnerable Vs 12.5% frail). Frail pts and pts in OncoMPI high-risk group experienced higher rate of toxicities. Median OS was 13.8 months (m) (95% CI 11.3-17.7). According to CGA, mOS was 19.53 m (95% CI 15.23-36-8) for fit pts, 12.83 m (95% CI 9.7-17.5) for vulnerable and 7.75 m (95% CI 2.73-30) for frail pts (p=0.005). OncoMPI confirmed a predictive value for 1-year survival, intermediate risk pts not reaching mOS at 1 year, and high-risk pts having median-1 year OS of 11.5 m (95%CI 9.7-NA), p=0.02. In multivariate analysis, oncoMPI and CGA were associated with survival (high risk oncoMPI: HR 5.5, 95%CI 1.25-24.7 p=0.02; fitness at CGA HR 0,552 95% 0,314-0,973; p=0.040) as well as CHT use (HR 0.24, 95% CI 0.11-0.51, p<0.005).
Conclusions
Both CGA and oncoMPI retain prognostic value for survival in mSTS. Our data show survival for fit pts comparable to younger adults. Pts not fit at CGA and pts within the oncoMPI high risk category should be offered an oncogeriatric management approach in order to optimize treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.