title: Prognostic factors for elderly patients with primary malignant bone and soft tissue tumors.
abstract: The number of patients with primary malignant bone and soft tissue tumors in Japan is increasing in line with the increasing size of the elderly population. The aim of the present study was to determine the prognostic factors of primary malignant bone or soft tissue tumors in elderly patients. Clinical data was obtained from 90 patients, aged ≥65 years, with primary malignant bone or soft tissue tumors (bone, 20 cases; and soft tissue, 70 cases), treated at the Osaka City University Hospital between 1993 and 2013. Clinical information prior to treatment and tumor type, location, size, depth, grade and American Society of Anesthesiologists-Physical Status (ASA-PS) score were evaluated in order to identify prognostic factors using the Cox proportional hazards regression model. In addition, 5-year survival rates were evaluated using the Kaplan-Meier method. The average follow-up period was 44.8 months and the 5-year overall survival rate was 77.5%. In the multivariate analysis, ASA-PS score and high-grade sarcoma were found to be associated with a poorer overall survival. No significant differences were observed between the patient group aged 65-74 years and that aged ≥75 years. In general, aging is associated with physically reduced function and an increased prevalence of comorbidities. It was therefore expected that increasing age may be a predictive factor for poor prognosis. However, the results of the present study suggested that ASA-PS score and tumor grade were significant factors associated with poor prognosis, whereas increasing age was not. Therefore, the treatment of elderly patients with primary bone and soft tissue tumors should not be based on age.
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwai
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hoshi
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takada
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Oebisu
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Masanari
authors.initials: M
authors.lastname: Aono
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Takami
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ieguchi
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka 545-8585, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
keywords: American Society of Anesthesiologists-Physical Status; bone and soft tissue tumor; elderly; prognostic factor; surgery; tumor grade