title: Advanced soft-tissue sarcoma in elderly patients: patterns of care and survival.
abstract: BACKGROUND
  There are no data regarding the management of advanced soft-tissue sarcoma (STS) in elderly patients.
  
  
  METHODS
  We retrospectively reviewed the charts of patients ≥75 years old diagnosed with metastatic or unresectable STS between 1991 and 2011 in 11 French and American centers.
  
  
  RESULTS
  The study included 361 patients. Of these, 223 patients (62%) received systemic therapy, whereas 123 patients (34%) were managed with best supportive care (BSC) only. Patients who received BSC were more likely to be ≥80 years, with performance status (PS) ≥ 2, Charlson comorbidity score ≥ 10, and metastatic disease. The median progression-free survival of patients treated with systemic therapy was 4 months (95% CI: 2.9-5.1). Thirty-six patients (16%) stopped chemotherapy because of toxicity. Median overall survival (OS) of patients managed with specific therapy was 10.9 months (95% CI: 8.3-13.5) versus 5.3 months (95% CI: 3.6-7.1) for patients managed with BSC (P = 0.001). On multivariate analysis, age ≥ 80 years, PS ≥ 2, and number of metastatic sites were the only independent factors associated with OS.
  
  
  CONCLUSIONS
  A high proportion of elderly patients with advanced STS were denied chemotherapy. Further efforts are needed to define better the optimal care for fit and unfit elderly patients with STS.
authors.affiliation: Department of Medical Oncology, Institut Bergonié, Bordeaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Garbay
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Maki
authors.affiliation: Department of Medicine, Centre Léon Bérard, Lyon.
authors.forename: J Y
authors.initials: JY
authors.lastname: Blay
authors.affiliation: Department of Medical Oncology, Centre Georges François Leclerc, Dijon.
authors.forename: N
authors.initials: N
authors.lastname: Isambert
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris.
authors.forename: S
authors.initials: S
authors.lastname: Piperno Neumann
authors.affiliation: Department of Medical Oncology, Centre Eugène Marquis, Rennes.
authors.forename: C
authors.initials: C
authors.lastname: Blay
authors.affiliation: Department of Medicine, Institut Gustave Roussy, Villejuif.
authors.forename: E
authors.initials: E
authors.lastname: Zanardi
authors.affiliation: Department of Medical Oncology, Hopital Cochin, Paris.
authors.forename: P
authors.initials: P
authors.lastname: Boudou-Rouquette
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris.
authors.forename: L
authors.initials: L
authors.lastname: Bozec
authors.affiliation: Department of Medical Oncology, Hopital La Timone, Marseille.
authors.forename: F
authors.initials: F
authors.lastname: Duffaud
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Bertucci
authors.affiliation: Department of Medical Oncology, Institut Bergonié, Bordeaux, France. Electronic address: a.italiano@bordeaux.unicancer.fr.
authors.forename: A
authors.initials: A
authors.lastname: Italiano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents
keywords: chemotherapy; elderly; palliative care; sarcoma; soft-tissue sarcoma