Browsing by Author "Elmegiri, Mohamed"

Background: Almost half of all patients with soft tissue sarcoma are over 65, and the proportion of older patients is increasing. Despite this, they have been underrepresented in clinical trials and only limited data is available to guide treatment decisions. Patients and Methods: Over 50-year-old patients treated for advanced soft tissue sarcoma at the Helsinki university hospital between January 2000 and July 2020 were included. Data on patient and tumor characteristics, treatment, and survival were retrospectively collected. 152 patients were included: 14.5% (n=22) were over 75, 34.2% (n=52) were 65-74 and 51.3% (n=78) were 50– 64 years old. Results: The outcomes of the oldest group differed from younger patients: as first line they were more likely to receive single-agent treatment (90.9% vs. 28.8% and 24.4%, p < 0.001) and had the lowest relative dose–intensity (70% vs. 88% and 95%, p<0.05). They experienced hematological grade three to four adverse events less frequently (38.1%, 56.9% and 72.7%, p = 0.031), and received fewer lines of treatment (medians 1, 2 and 2, p=0.01). They did not have an association between further lines of therapy and improved survival. Compared to the youngest group, the oldest patients had a greater risk of dying (HR 1.7, 95% CI 1.0-2.8, p=0.041) and their median overall survival was only 7.4 months, compared to 14.3 and 12.9 months in the two younger groups. Conclusion: These findings suggest that older patients tolerate chemotherapy when treatment is tailored to their needs but may not benefit as much as younger patients.