Background

Elderly STS patients (pts) have different clinicopathological feature and health status compared to younger pts. The optimal management for mSTS remained unclear.

Methods

From January 2011 to December 2017, mSTS pts in National Taiwan University Hospital and ≥65-years-old at the time of metastatic disease diagnosis were included. The clinicopathological features and the chemotherapy (C/T) received were collected.

Results

61 mSTS pts ≥65 y/o were identified; the median age was 74 (range 65- 89); male: female 46%: 54%. The most common histologies were liposarcoma (23%), angiosarcoma (19.7%), and sarcoma NOS (18%). 50 (82%) pts received at least one-line of C/T and the median lines of C/T received was 1 (range 1-5). Anthracycline (exclusive of liposomal doxorubicin (lip-dox)) and ifosfamide were administered to 16 (32%) and 8 (16%) pts; 16 (32%) pts received combination chemotherapy as first-line systemic treatment (tx). Another 9 (18%) and 6 (12%) of patients received lip-dox and oral cyclophosphamide (o-cyclo), as first-line systemic tx. With a median follow-up time of 6.8 months (mos), the median OS was 9.57 mos (95% CI 6.03-22.87 mos); pts who received at least one line of C/T had a numerically but not statistically significant better OS as compared to those who did not receive any C/T (17.50 vs 6.83 mos, p = 0.25). The benefit of systemic C/T were similar for pts aged 65-74 vs ≥ 75 (p for interaction = 0.72). In terms of tx efficacy, the PFS and 1-year OS rate of first-line lip-dox, o-cyclo, and doxorubicin were 7.37 mos and 42%; 16.29 mos and 83%, and 6.97 mos and 40%, respectively. The histologies of mSTS pts who received o-cyclo and lip-dox tx are shown in the table. In multivariate Cox model, only liposarcoma histology had a trend for OS impact (HR 0.4, 95% CI 0.15-1.08, p = 0.07). Table:

410P Histology distribution of pts receiving lip-dox and o-cyclo as first-line therapy

Conclusions

Systemic C/T should be considered for elderly mSTS pts. Less toxic tx such as o-cyclo or lip-dox could be considered for selective histologies.

Legal entity responsible for the study

The authors.

Funding

Taiwan Maple Orthopedic Association.

Disclosure

All authors have declared no conflicts of interest.