TY - JOUR
T1 - Long-Term Outcome After Surgery for a Localized Retroperitoneal Soft Tissue Sarcoma in Elderly Patients
T2 - Results from a Retrospective, Single-Center Study
AU - Sourrouille, I.
AU - Macovei, R.
AU - Faron, M.
AU - Le Péchoux, C.
AU - Mir, O.
AU - Adam, J.
AU - Dumont, S.
AU - Terrier, P.
AU - Le Cesne, A.
AU - Honoré, C.
N1 - Publisher Copyright:
© 2018, Society of Surgical Oncology.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: To evaluate short- and long-term results after curative surgery for a retroperitoneal sarcoma (RPS) in elderly patients. Methods: We retrospectively analyzed data of all patients operated in our single, tertiary care center for a nonmetastatic RPS and identified patients aged 70 years and older. Results: Among 296 patients with an RPS treated between 1994 and 2015, 60 (20%) were aged 70 years and older (median age 74 years; range 70–85). The median tumor size was 24 cm (range 6–46). Forty-six patients (77%) had mass-related symptoms at the time of diagnosis. The most frequent histological subtypes were de-differentiated liposarcoma (53%, n = 32) and well-differentiated liposarcoma (35%, n = 21). Twenty-two patients (37%) had perioperative radiotherapy and/or chemotherapy. Fifty-eight patients (97%) had macroscopically complete resection. The postoperative mortality was 8% and severe morbidity (Dindo/Clavien ≥ 3) was 32%. A reoperation was required for ten patients (17%). After a median follow-up of 20 months (range 1–121), the 5-year overall survival (OS) rate was 90% (95% confidence interval [CI] 79–100%), and median OS was not reached. The cancer-specific death rate was 88%. No prognostic factor for disease-specific survival was detected. The 5-year disease-free survival (DFS) rate was 52% (95% CI 33–84%) and 5-year locoregional recurrence-free survival rate was 52% (95% CI 33–84%). Median DFS was 94 months (95% CI 35–NA). Reoperation after inappropriate surgery and postoperative morbidity were independent predictive factors of locoregional relapse. No predictive factors of distant metastasis were found. Conclusions: Curative surgery is feasible in selected elderly patients but with higher mortality and morbidity rates than in younger patients. It enables a prolonged survival. Future studies should focus on selection process to minimize postoperative mortality and morbidity.
AB - Background: To evaluate short- and long-term results after curative surgery for a retroperitoneal sarcoma (RPS) in elderly patients. Methods: We retrospectively analyzed data of all patients operated in our single, tertiary care center for a nonmetastatic RPS and identified patients aged 70 years and older. Results: Among 296 patients with an RPS treated between 1994 and 2015, 60 (20%) were aged 70 years and older (median age 74 years; range 70–85). The median tumor size was 24 cm (range 6–46). Forty-six patients (77%) had mass-related symptoms at the time of diagnosis. The most frequent histological subtypes were de-differentiated liposarcoma (53%, n = 32) and well-differentiated liposarcoma (35%, n = 21). Twenty-two patients (37%) had perioperative radiotherapy and/or chemotherapy. Fifty-eight patients (97%) had macroscopically complete resection. The postoperative mortality was 8% and severe morbidity (Dindo/Clavien ≥ 3) was 32%. A reoperation was required for ten patients (17%). After a median follow-up of 20 months (range 1–121), the 5-year overall survival (OS) rate was 90% (95% confidence interval [CI] 79–100%), and median OS was not reached. The cancer-specific death rate was 88%. No prognostic factor for disease-specific survival was detected. The 5-year disease-free survival (DFS) rate was 52% (95% CI 33–84%) and 5-year locoregional recurrence-free survival rate was 52% (95% CI 33–84%). Median DFS was 94 months (95% CI 35–NA). Reoperation after inappropriate surgery and postoperative morbidity were independent predictive factors of locoregional relapse. No predictive factors of distant metastasis were found. Conclusions: Curative surgery is feasible in selected elderly patients but with higher mortality and morbidity rates than in younger patients. It enables a prolonged survival. Future studies should focus on selection process to minimize postoperative mortality and morbidity.
UR - http://www.scopus.com/inward/record.url?scp=85047292623&partnerID=8YFLogxK
U2 - 10.1245/s10434-018-6529-z
DO - 10.1245/s10434-018-6529-z
M3 - Article
C2 - 29797115
AN - SCOPUS:85047292623
SN - 1068-9265
VL - 25
SP - 2201
EP - 2208
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 8
ER -