Sarcomas in patients over 90: natural history and treatment. A nationwide study over 6 years.
Fiche publication
Date publication
mars 2019
Journal
International journal of cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BOUCHE Olivier, Dr CHAIGNEAU Loïc, Dr EYMARD Jean-Christophe, Pr KURTZ Jean-Emmanuel, Dr RIOS Maria
Tous les auteurs :
Basse C, Italiano A, Penel N, Mir O, Chemin C, Toulmonde M, Duffaud F, Le Cesne A, Chevreau C, Maynou C, Anract P, Gouin F, Rios M, Firmin N, Kurtz JE, Kerbrat P, Piperno-Neumann S, Bertucci F, Rosset P, Isambert N, Bompas E, Dubray-Longeras P, Fiorenza F, Le Maignan C, Chaigneau L, Thyss A, Bouché O, Eymard JC, Lair CD, Adam J, Karanian M, Lebbé C, Dupré A, Meeus P, Brahmi M, Dufresne A, Ducimetière F, Ray-Coquard I, Blay JY
Lien Pubmed
Résumé
Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinico-pathological presentation, and outcome of sarcoma patients over 90 recorded in the Netsarc.org French national database. NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow-up are collected in a database Information of patients registered from January 1st 2010 to December 31st 2016 in Netsarc were collected, analyzed and compared with the younger population. Patients with sarcomas aged>90 have almost exclusively sarcomas with complex genomics (92·0% vs 66·3%), are less frequently metastatic (5·3% vs 14·7%) at diagnosis, have more often superficial tumours (39·8% vs 14·7%), as well as limbs and head and neck sites (75·2% vs 38·7%) (all p<0·001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p<0·001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80-90. However, local relapse free, metastatic relapse free, and relapse-free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p<0·001). Patients over 90 who were not operated had a worse overall survival than younger patients (9·9 vs 27·3 months, p<0·001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows. This article is protected by copyright. All rights reserved.
Référence
Int. J. Cancer. 2019 Mar 28;: