Abstract 69P
Background
Elderly patients (pts) with soft tissue sarcoma (STS) are underrepresented in clinical trials and evidence-based management guidelines in this population remain scarce. The objective of this study is to describe the characteristics of pts over 70 years(y) with STS and compare them with the younger population. Moreover, we analyze the variables that impact overall survival (OS) and treatment tolerance.
Methods
Is a single-center retrospective study of a cohort of pts aged ≥18y from the Hospital G. U. Gregorio Marañón database with STS diagnosis between 2012 and 2023. Demographic data, histological subtype, and extent of disease at diagnosis were analyzed.
Results
Out of 1375 pts identified for this analysis, 23.3% (320) were ≥70 y and 76.7% (1055) were <70y. The most frequent histological subtypes were liposarcoma (LPS) (29.7% 93/313) and undifferentiated pleomorphic sarcoma (UPS) (23.3% 73/313) in elderly pts (>70y), LPS (26.4% 272/1030) and leiomyosarcoma (LMS) 11.9% 123/1030) in younger pts. Synovial sarcoma was more common in younger pts (4.9% vs 0.9%). UPS was more common in older pts (23.3% vs 9.8%). LPS and LMS were similar in both groups. Elderly pts had a higher proportion of grade 3 tumors (41% 90/219 vs 33% 199/602), higher proportion of larger tumors (>=5cm) (71.9% 197/274 vs 64.5% 575/892), and higher proportion of advanced disease (aSTS) at diagnosis (47% 146/312 vs 41% 423/1037). Treatment received by pts aged <70y was compared with treatment received by elderly pts. No significant differences were seen in surgical or radiotherapy interventions, but younger pts received more chemotherapy in localized disease (younger: 17% 104/613; elderly 6,6% 11/166) and metastatic settings (younger 71.4% 302/423; elderly 48.6% 71/146). Median OS in aSTS pts <70y was 16.2 months (95%CI, 14.2-18.3) while OS in elderly pts was 8.9 months (95% CI, 7.1-10.7) p <0.0001. OS in localized pts was not calculated because of missing data.
Conclusions
Elderly pts (≥70y) in our cohort present with more advanced and aggressive disease and receive less chemotherapy treatment. Elderly pts with aSTS have worse OS than younger pts. Further studies are needed to help assess which variables determine these results and therefore influence treatment decisions.
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.