Bone versus Soft-Tissue Sarcomas in the Elderly

Abstract

Purpose. To compare survival rates in the elderly with bone versus soft-tissue sarcomas. Methods. Records of 12 men and 8 women aged 70 to 91 (mean, 77) years with bone or soft-tissue sarcomas were retrospectively reviewed. The grade, size, location, and stage of the sarcomas, as well as their surgical margins, treatment modalities, local recurrence, metastasis, and prognosis were recorded. The mean follow-up period was 37 (range, 2–137) months. Their 5-year survival rates were estimated using the Kaplan-Meier method, and compared with 110 younger controls aged 9 to 69 (mean, 45) years during the same period. There was no significant difference between the older patients and younger controls regarding tumour grading (p=0.068, Chi squared test), stage, and pathological diagnosis. Results. Six patients had bone and 14 had soft-tissue sarcomas. Of the 6 bone sarcomas, 3 were malignant fibrous histiocytomas, 2 were osteosarcomas, and one was a chordoma; all were high grade, except for the chordoma. Of the 14 soft-tissue sarcomas, 9 were malignant fibrous histiocytomas, 3 were myxofibrosarcomas, one was a liposarcoma and one an extraskeletal osteosarcoma; all were high grade except for 2 of the myxofibrosarcomas and the liposarcoma. Of the 110 younger controls, 30 had bone and 80 had soft-tissue sarcomas; 44 were low grade and 66 were high grade. The 5-year survival rate was significantly lower in older patients than in younger controls (35% vs 65%, p=0.048). Regarding bone versus soft-tissue sarcomas, the 5-year survival rate was not significantly different among older patients (0% vs 52%, p=0.068) or younger controls (61% vs 66%, p=0.863). The difference was also not significant for older patients versus younger controls with bone sarcomas (0% vs 61%, p=0.284) or soft-tissue sarcomas (52% vs 66%, p=0.368), for older patients with high- versus low-grade sarcomas (17% vs 100%, p=0.314), for older patients with sarcomas located in the limbs versus the trunk (39% vs 38%, p=0.233), as well as for older patients versus younger controls with low-grade sarcomas (100% vs 92%, p=0.512) or high-grade sarcomas (17% vs 46%, p=0.269). Conclusion. Survival rates tend to be lower in older patients with sarcomas, especially when the sarcoma is of bone and high grade.