title: Worse Survival in Elderly Patients with Extremity Soft-Tissue Sarcoma.
abstract: Nearly half of soft-tissue sarcoma (STS) patients are over the age of 65, and the behavior of cancer in these elderly patients is poorly understood. The aim of this study was to assess the impact of age, sarcoma histotype, grade, stage, and treatment modalities on survival of extremity STS (ESTS) patients.
  
  
  
  Patients ≥18 years diagnosed with ESTS between 1989 and 2008 were selected from the Netherlands Cancer Registry. Survival rates and patient and treatment characteristics were analyzed for all patients. Relative survival and relative excess risk of death were estimated for young (<65 years) and older (>65 years) patients.
  
  
  
  Overall, 3066 patients were included in this study. Histotype was different between young (<65 years) and elderly (>65 years) patients (p < 0.001). Patients over the age of 65 were more often diagnosed with high-stage ESTS and an increasing proportion of high-grade ESTS (p < 0.001). The proportion of patients who received no treatment increased with age, and the elderly received fewer combined-modality treatments. Age was significantly associated with relative 5-year survival [72.7 % for younger patients and 43.8 % for the oldest elderly (>85 years)]. In multivariable analysis, age still remained a significant prognostic factor.
  
  
  
  Different distribution of sarcoma histotypes, more high-stage and high-grade sarcomas at diagnosis, less aggressive treatment, and worse survival rates emphasize the need for optimizing sarcoma research and care of the elderly.
authors.affiliation: Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. m.hoven@telfort.nl.
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Hoven-Gondrie
authors.affiliation: Department of Surgery, University of Leiden, Leiden University Medical Center, Leiden, The Netherlands.|Department of Gerontology and Geriatrics, University of Leiden, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Bastiaannet
authors.affiliation: Comprehensive Cancer Center Netherlands, Utrecht, The Netherlands.
authors.forename: Vincent K Y
authors.initials: VK
authors.lastname: Ho
authors.affiliation: Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: van Leeuwen
authors.affiliation: Department of Surgery, University of Leiden, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Gerrit-Jan
authors.initials: GJ
authors.lastname: Liefers
authors.affiliation: Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hoekstra
authors.affiliation: Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Albert J H
authors.initials: AJ
authors.lastname: Suurmeijer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005121:Extremities / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009426:Netherlands; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate