title: Impact of geriatric factors on surgical and prognostic outcomes in elderly patients with soft-tissue sarcoma.
abstract: OBJECTIVE
  Patients aged ≥65 years requiring surgery for soft-tissue sarcoma are a concern in an aging society. We aimed to reveal the association of clinical/geriatric factors with survival period or postoperative events in such patients who underwent surgery.
  
  
  METHODS
  We enrolled patients aged ≥65 years who underwent surgery for localized soft-tissue sarcoma at five institutions. We retrospectively collected clinical/geriatric factors and laboratory data, and analyzed their association with outcomes using univariate and multivariate analyses.
  
  
  RESULTS
  Among the 202 patients included, mean age at presentation was 73 years. Surgical margin was R0 in 139 patients (69%). The Eastern Cooperative Oncology Group performance status was ≥2 in 15 (7%). Thirty patients (15%) showed thinness (body mass index <18.49 kg/cm2). High-sensitivity-modified Glasgow prognostic score ≥1 was seen in 52 patients (26%). Multivariate analysis showed that R1 surgical margin was significantly correlated with poor sarcoma-specific survival (hazard ratio for R1 vs. R0, 3.17; P = 0.001) and event-free survival (hazard ratio for R1 vs. R0, 2.56; P < 0.001). Higher Eastern Cooperative Oncology Group performance status was significantly associated with poor sarcoma-specific survival (hazard ratio for ≥2 vs. 0 or 1, 2.15; P = 0.038), and higher sensitivity-modified Glasgow prognostic score was significantly associated with poor event-free survival (hazard ratio for ≥1 vs. 0, 1.74; P = 0.046). Severe thinness (body mass index <16.00) was a risk factor for postoperative events (odds ratio for body mass index <16.00 vs. ≥16.00, 8.15, P = 0.010).
  
  
  CONCLUSIONS
  Negative surgical margin was associated with better survival. Coexisting conditions had an impact on outcomes in elderly soft-tissue sarcoma patients.
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsuda
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo.|Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ogura
authors.affiliation: Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kobayashi
authors.affiliation: Division of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Kanagawa.
authors.forename: Toru
authors.initials: T
authors.lastname: Hiruma
authors.affiliation: Division of Orthopedic Surgery, Chiba Cancer Center, Chiba.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Iwata
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Asano
authors.affiliation: Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.affiliation: Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chuman
authors.affiliation: Division of Orthopedic Surgery, Chiba Cancer Center, Chiba.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Hideo
authors.initials: H
authors.lastname: Morioka
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo.|Department of Orthopedic Surgery, Graduate School of Medicine, The University of Teikyo, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kawano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005853:Geriatrics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D011182:Postoperative Care; D011379:Prognosis; D012307:Risk Factors; D012509:Sarcoma / Q000601:surgery*; D016896:Treatment Outcome
keywords: elderly; geriatric factors; soft-tissue sarcoma