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Journal Articles International Journal of Cancer Year : 2019

Sarcomas in patients over 90: Natural history and treatment—A nationwide study over 6 years

Antoine Italiano
Olivier Mir
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  • PersonId : 892590
François Gouin
  • Function : Author
  • PersonId : 919836
Nelly Firmin
Pierre Kerbrat
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  • PersonId : 989757
Philippe Rosset
  • Function : Author
Nicolas Isambert
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  • PersonId : 940320
Fabrice Fiorenza
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Antoine Thyss
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  • PersonId : 892872
Jean-Christophe Eymard
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  • PersonId : 1123379
Corinne Delcambre Lair
  • Function : Author
Aurélien Dupré
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  • PersonId : 1000551
Pierre Méeus
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  • PersonId : 940187
Mehdi Brahmi
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  • PersonId : 966414
Isabelle Ray-Coquard
Jean‐yves Blay


Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinicopathological presentation, and outcome of sarcoma patients over 90 recorded in the French national database. NETSARC ( is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow-up are collected in a database Information of patients registered from January 1, 2010, to December 31, 2016, in NETSARC were collected, analyzed and compared to the younger population. Patients with sarcomas aged >90 have almost exclusively sarcomas with complex genomics (92.0% vs. 66.3%), are less frequently metastatic (5.3% vs. 14·7%) at diagnosis, have more often superficial tumors (39.8% vs. 14.7%), as well as limbs and head and neck sites (75.2% vs. 38.7%) (all p < 0.001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p < 0.001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80-90. However, local relapse-free survival, metastatic relapse-free survival and relapse-free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p < 0.001). Patients over 90 who were not operated had worse overall survival than younger patients (9.9 vs. 27.3 months, p < 0.001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse-free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows.
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Dates and versions

hal-02504786 , version 1 (19-09-2023)



Clémence Basse, Antoine Italiano, Nicolas Penel, Olivier Mir, Claire Chemin, et al.. Sarcomas in patients over 90: Natural history and treatment—A nationwide study over 6 years. International Journal of Cancer, 2019, 145 (8), pp.2135-2143. ⟨10.1002/ijc.32307⟩. ⟨hal-02504786⟩
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