title: Soft tissue sarcoma: why not treated?
abstract: BACKGROUND
  Soft tissue sarcomas (STS) are uncommon malignancies and elderly STS patients have been reported to receive less definitive treatment compared to young STS patients. The present study was performed to investigate whether withholding treatment was based on disease specific aspects, patients' general health condition, comorbidity or a combination of these.
  
  
  METHODS
  Patients with primary STS, registered by the Comprehensive Cancer Center North-Netherlands (CCCN) from 1989 to 1999, were analyzed retrospectively with regard to the inclusion-criteria: no primary anti-tumor treatment.
  
  
  RESULTS
  From 1989 to 1999, 620 patients (including 56 Kaposi sarcoma) were registered with primary STS. Seventy-six patients (13%) were registered as untreated. Nineteen patients were excluded. Records of 57 patients, median age 71 years (range 23-92, 40 patients > or =65 years, 17 patients < 65 years) were examined. The reasons for no treatment were irresectability of the sarcoma (65%), metastatic disease (11%), comorbidity (4%), poor general health (5%), death prior to therapy (7%) and refusal of therapy (3%) (motivation not documented in 5%).
  
  
  CONCLUSIONS
  Thirteen percent of all STS patients within the CCCN region were not treated, 70% of these patients were elderly. Withholding treatment was mostly disease-related (76%), e.g. irresectable retroperitoneal STS or metastatic disease; for 19% of the patients, it was related to their poor general health. The decision to refrain from cancer treatment was justifiable in all these STS patients.
authors.affiliation: Department of Surgical Oncology, Groningen University Hospital, Groningen, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Farshadpour
authors.forename: M
authors.initials: M
authors.lastname: Schaapveld
authors.forename: A J H
authors.initials: AJ
authors.lastname: Suurmeijer
authors.forename: A N M
authors.initials: AN
authors.lastname: Wymenga
authors.forename: R
authors.initials: R
authors.lastname: Otter
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009367:Neoplasm Staging; D009426:Netherlands; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000628:therapy*; D028761:Withholding Treatment