{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T23:38:21Z","timestamp":1789256301687,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministero della Salute Grant","award":["GR-2016-02364834"],"award-info":[{"award-number":["GR-2016-02364834"]}]},{"name":"Ricerca Corrente funding from the Italian Ministry of Health","award":["GR-2016-02364834"],"award-info":[{"award-number":["GR-2016-02364834"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Incidences of soft tissue sarcomas (STS) steadily increase with age. Yet, despite the high prevalence in advanced age, older patients (pts) are underrepresented in sarcoma clinical trials and evidence-based guidelines for chemotherapy are lacking. International oncological societies suggest using geriatric tools to evaluate older patients with cancer to optimise treatment indication. Comprehensive geriatric assessment (CGA) is a multidimensional assessment of older subjects, based on which pts can be classified as fit, vulnerable or frail. Onco-MPI (multidimensional prognostic index) is a CGA-based score which also considers tumour characteristics, classifying pts into three risk groups of death at one year: high-risk, intermediate-risk and low-risk. Methods: This is a single-centre retrospective study which aims at describing real-word management and outcomes of older pts with advanced stage STS and at assessing the ability of CGA and onco-MPI to predict survival in these pts. Consecutive pts with advanced stage STS aged 70 years or older and treated at the Istituto Oncologico Veneto from January 2009 to June 2020 were retrieved from a prospectively maintained database. Pts\u2019 demographics, CGA assessments and tumour characteristics were analysed. Statistical analysis was performed with R version 3.4.3 Results: Out of 101 pts, with a median age of 77 years, 76 received chemotherapy (75.3%), which was anthracycline-based for 46 pts (60.5%). Anthracyclines were used in a higher proportion in fit pts (58.9% fit vs. 45.1% vulnerable vs. 12.5% frail pts). Frail pts and pts in the onco-MPI high-risk group experienced a higher rate of chemotherapy-related toxicities. Median OS was 13.8 months (95% CI 11.3\u201317.7 months). According to CGA, the median OS was 19.53 months (95% CI 15.23\u201336.8) for fit pts, 12.83 months (95% CI 9.7\u201317.5) for vulnerable and 7.75 months (95% CI 2.73\u201330) for frail pts (p = 0.005). Onco-MPI confirmed a predictive value for 1-year survival with intermediate risk pts not reaching a median OS at 1 year, and high-risk pts having a median one-year OS of 11.5 months (95%CI 9.7\u2013NA), p = 0.02. In multivariate analysis, onco-MPI and CGA were associated with survival (high risk onco-MPI: HR 5.5, 95%CI 1.25\u201324.7 p = 0.02; fitness at CGA HR 0.552 95% 0.314\u20130.973; p = 0.040) as well as chemotherapy use (HR 0.24, 95% CI 0.11\u20130.51, p &lt; 0.005). Conclusions: Both CGA and onco-MPI retain prognostic value for survival in pts with metastatic STS. Pts frail\/vulnerable at CGA and pts within the onco-MPI high risk category should be offered an oncogeriatric management approach in order to optimise treatment-related survival and reduce toxicity.<\/jats:p>","DOI":"10.3390\/cancers15041043","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T01:32:05Z","timestamp":1675819925000},"page":"1043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Management and Outcomes of Older Patients (Age \u2265 70 Years) with Advanced Soft Tissue Sarcoma and Role of Geriatric Assessment and Oncological Multidimensional Prognostic Index (Onco-MPI) in a Real-World Setting"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6449-6402","authenticated-orcid":false,"given":"Benedetta","family":"Chiusole","sequence":"first","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tortorelli","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Galiano","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Murtas","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3878-3595","authenticated-orcid":false,"given":"Selma","family":"Ahcene-Djaballah","sequence":"additional","affiliation":[{"name":"Oncology 3, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Tierno","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8259-5025","authenticated-orcid":false,"given":"Eleonora","family":"Bergo","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Banzato","sequence":"additional","affiliation":[{"name":"Cardiology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Gatti","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Di Maggio","sequence":"additional","affiliation":[{"name":"Oncologic Radiology Unit, Department of Radiology and Medical Physics, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Sergi","sequence":"additional","affiliation":[{"name":"Department of Medicine (DIMED), Geriatric Division, University of Padova, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5405-6243","authenticated-orcid":false,"given":"Marco","family":"Rastrelli","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy"},{"name":"Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Sbaraglia","sequence":"additional","affiliation":[{"name":"Surgical Pathology Unit, Padua University Hospital, 35121 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorina","family":"Zagonel","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2583-5226","authenticated-orcid":false,"given":"Antonella","family":"Brunello","sequence":"additional","affiliation":[{"name":"Oncology 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer statistics, 2016","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J. 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