with 修饰的对吗？

Not long ago considered a grim, unrelenting, and malignant disease entity with few effective treatment options, the clinical narrative of HCM has evolved substantially,Over the last 20 years, in combination with increased clinical recognition including benign low-risk subgroups without significant symptoms or disability,effective management strategies for major HCM complications have emerged which improve clinical course, resulting in substantially lower mortality and morbidity rates, with enhanced likelihood of achieving normal longevity with good quality of life for both adults and children with survival possible to age 70s to 90s(Central Illustration, Figures 1 and 2).

不久前，还认为HCM是一种有效治疗方案很少的严峻、无情和恶性的疾病，但在过去20年中，对HCM的临床叙述发生了实质性的改变，结合增加的临床识别（包括无明显症状或残疾的良性低风险亚组的识别），针对主要HCM并发症的有效管理策略应运而生，改善了临床病程，显著降低了死亡率和发病率，提高了成人和儿童患者达到正常寿命和70至90岁依然有良好生活质量的可能性（中心插图，图1和图2）。

grim, unrelenting, and malignant 翻译的恰当吗？

with survival possible to age 70s to 90s修饰的对吗？