TY - JOUR
T1 - Outcomes of elderly patients undergoing curative resection for retroperitoneal sarcomas
T2 - analysis from the US Sarcoma collaborative
AU - Wilkinson, Katheryn Hope
AU - Ethun, Cecilia G.
AU - Hembrook, Matthew
AU - Bedi, Meena
AU - Charlson, John
AU - Mogal, Harveshp
AU - Tsai, Susan
AU - Christians, Kathleen
AU - Tran, Thuy B.
AU - Poultsides, George
AU - Grignol, Valerie
AU - Howard, J. Harrison
AU - Tseng, Jennifer
AU - Roggin, Kevin K.
AU - Chouliaras, Konstantinos
AU - Votanopoulos, Konstantinos
AU - Cullinan, Darren
AU - Fields, Ryan C.
AU - Weber, Sharon
AU - Gamblin, Thomas Clark
AU - Cardona, Kenneth
AU - Clarke, Callisia N.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Background: The postoperative outcomes of elderly patients undergoing resection of retroperitoneal sarcomas (RPS) have not been widely studied. Methods: Patients undergoing surgical resection for primary or recurrent RPS between 2000 and 2015 at participating US Sarcoma Collaborative institutions were identified. Patient demographics, perioperative morbidity, mortality, length of stay, discharge to home, disease-specific survival, and disease-free survival were compared between elderly (≥70 y, n = 171) and nonelderly (<70 y, n = 494) patients. Results: There was no difference in perioperative morbidity (total and major complications elderly versus nonelderly: 39% versus 35%; P = 0.401 and 18% versus 17%; P = 0.646, respectively) or mortality between elderly and nonelderly patients with each group experiencing a 1% 30-d mortality rate. Length of stay and 30-d readmission rates were similar (elderly versus nonelderly; 7 d interquartile range [IQR: 5-9] versus 6 d [IQR: 4-9], P = 0.528 and 11% versus 12%, P = 0.667). Elderly patients were more likely to be discharged to a skilled nursing or rehabilitation facility (elderly versus nonelderly; 19% versus 7%, P < 0.001). There was no difference in 3-y disease-free survival between the elderly and nonelderly patients (41% versus 43%, P = 0.65); however, elderly patients had a lower 3-y disease-specific survival (60% versus 76%, P < 0.001). In elderly patients, the presence of multiple comorbidities and high-grade tumors were most predictive of outcomes. Conclusions: Advanced age was not associated with an increased risk of perioperative morbidity and mortality following resection of RPS in this multi-institutional review. Although short-term oncologic outcomes were similar in both groups, the risk of death after sarcoma recurrence was higher in elderly patients and may be related to comorbidity burden and tumor histology.
AB - Background: The postoperative outcomes of elderly patients undergoing resection of retroperitoneal sarcomas (RPS) have not been widely studied. Methods: Patients undergoing surgical resection for primary or recurrent RPS between 2000 and 2015 at participating US Sarcoma Collaborative institutions were identified. Patient demographics, perioperative morbidity, mortality, length of stay, discharge to home, disease-specific survival, and disease-free survival were compared between elderly (≥70 y, n = 171) and nonelderly (<70 y, n = 494) patients. Results: There was no difference in perioperative morbidity (total and major complications elderly versus nonelderly: 39% versus 35%; P = 0.401 and 18% versus 17%; P = 0.646, respectively) or mortality between elderly and nonelderly patients with each group experiencing a 1% 30-d mortality rate. Length of stay and 30-d readmission rates were similar (elderly versus nonelderly; 7 d interquartile range [IQR: 5-9] versus 6 d [IQR: 4-9], P = 0.528 and 11% versus 12%, P = 0.667). Elderly patients were more likely to be discharged to a skilled nursing or rehabilitation facility (elderly versus nonelderly; 19% versus 7%, P < 0.001). There was no difference in 3-y disease-free survival between the elderly and nonelderly patients (41% versus 43%, P = 0.65); however, elderly patients had a lower 3-y disease-specific survival (60% versus 76%, P < 0.001). In elderly patients, the presence of multiple comorbidities and high-grade tumors were most predictive of outcomes. Conclusions: Advanced age was not associated with an increased risk of perioperative morbidity and mortality following resection of RPS in this multi-institutional review. Although short-term oncologic outcomes were similar in both groups, the risk of death after sarcoma recurrence was higher in elderly patients and may be related to comorbidity burden and tumor histology.
KW - Cancer directed surgery
KW - Elderly
KW - Sarcoma
UR - http://www.scopus.com/inward/record.url?scp=85051762456&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2018.07.050
DO - 10.1016/j.jss.2018.07.050
M3 - Article
C2 - 30502242
AN - SCOPUS:85051762456
SN - 0022-4804
VL - 233
SP - 154
EP - 162
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -