# Oncological Outcomes and Postoperative Complications for Localized Soft Tissue Sarcomas of the Extremities and Trunk Wall in Patients Aged 85 Years or Older

## TL;DR

This study examines the outcomes of surgery for soft tissue sarcomas in patients aged 85 or older, finding acceptable survival rates and manageable complication risks.

## Contribution

The study provides empirical evidence on surgical outcomes for elderly patients with soft tissue sarcomas, a population with limited prior data.

## Key findings

- Surgically treated patients had a 77% two-year overall survival rate.
- Approximately one-third of surgical patients experienced postoperative complications.
- Older age, poor performance status, trunk location, and larger tumors were linked to complications.

## Abstract

Surgical treatment for soft tissue sarcoma in patients aged ≥ 85 remains challenging due to limited evidence. Among 37 patients with localized disease, 25 underwent surgery. Patient and tumor profiles were similar between patients who underwent surgery and those who did not. The two-year overall survival among surgically treated patients was 77%, and approximately one-third experienced complications. Older age, poor performance status, trunk location, and larger tumors were associated with complications. Although no prognostic factors for overall survival were identified, surgical treatment appears reasonable, given its acceptable complication rates and potential survival benefits.

Objectives: The management of soft tissue sarcoma in patients aged ≥ 85 years remains a clinical dilemma, as evidence to guide treatment decisions in this population is limited. Here, we aimed to compare the clinical characteristics of patients aged ≥ 85 years who underwent surgery with those who did not, to identify factors influencing surgical decision-making. We also assessed the oncological outcomes and postoperative complications in the patients. Methods: We reviewed 37 consecutive patients with localized disease involving either the extremities or trunk wall, with a median age of 89.0 years. No significant differences in demographics or clinical characteristics were observed between patients who underwent surgery and those who received conservative management. Among the 37 patients, 25 underwent surgery with curative intent. Results: The two-year overall survival rate among surgically treated patients was 77%, with local recurrence-free survival and metastasis-free survival rates of 77% and 57%, respectively. Postoperative complications occurred in approximately one-third of the cases. Compared to those without complications, patients with complications were older (p = 0.025), had poorer performance status (p = 0.017), were likely to have trunk involvement (p = 0.01), and had larger tumor sizes (p = 0.025). No significant prognostic factors for overall survival were identified. Conclusions: While surgery is not without risk, our results can provide useful information for both physicians and patients to discuss and explain possible outcomes with surgical treatment.