Journal article
Extremity Soft Tissue Sarcoma Care in the Elderly: Insights into the Generalizability of NCI Cancer Trials
Annals of surgical oncology, Vol.17(7), pp.1732-1738
07/01/2010
DOI: 10.1245/s10434-010-1034-z
PMID: 20354801
Abstract
The projected increase in older persons in the United States, their underrepresentation in clinical trials, and the rarity of extremity soft tissue sarcomas (ESTS) limit our understanding of ESTS care in the elderly. We explored the extent of older age (a parts per thousand yen65 years) on patterns of ESTS care in NCI-sponsored population-based dataset.
Using the 1991-2006 Surveillance Epidemiology and End Results registries, we identified 2586 Medicare aged persons a parts per thousand yen65 years with ESTS. We compared demographics, tumors, and treatments by age category. Multivariable analyses were used to examine the effect of older age on ESTS care and survival, adjusting for covariates.
More than 30% of adult ESTS were diagnosed in patients older than 65 years. A significant trend was observed between increasing age and decreased use of sarcoma-directed surgery and delivery of radiotherapy after limb-sparing surgery for high-grade or T2 tumors. Limb amputation rates did not vary by age. However, both African-American (odds ratio [OR] 1.85, 95% confidence interval [95% CI] 1.05-3.27, P = .0341) and Hispanic races (OR 2.17, 95% CI 1.27-3.70, P = .0044) predicted higher rates of limb amputation than whites. Although our multivariable analyses showed that decreased use of sarcoma-directed surgery was only limited to age 85 + years, it also showed that older age predicted poorer cancer-specific mortality following sarcoma-directed surgery (P < .0001).
In this US population-based study, the decreased use of sarcoma-directed surgery in the elderly was only limited to those older than 85 years. The association between older age and increased cancer-related mortality deserves future investigation to carefully examine potential effects of undertreatment.
Details
- Title: Subtitle
- Extremity Soft Tissue Sarcoma Care in the Elderly: Insights into the Generalizability of NCI Cancer Trials
- Creators
- Waddah B. Al-Refaie - University of MinnesotaElizabeth B. Habermann - University of MinnesotaVikas Dudeja - University of MinnesotaSelwyn M. Vickers - University of MinnesotaTodd M. Tuttle - University of MinnesotaEric H. Jensen - University of MinnesotaBeth A. Virnig - University of Minnesota
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.17(7), pp.1732-1738
- DOI
- 10.1245/s10434-010-1034-z
- PMID
- 20354801
- ISSN
- 1068-9265
- eISSN
- 1534-4681
- Publisher
- Springer Nature
- Number of pages
- 7
- Grant note
- Ladies Cancer Research Center Endowment Fund The 2008 Veterans of Foreign Wars RC2MD004797 / NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Minority Health & Health Disparities (NIMHD)
- Language
- English
- Date published
- 07/01/2010
- Academic Unit
- Anatomy and Cell Biology; Surgery
- Record Identifier
- 9985244679002771
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