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Øines MN, Smith HG, Preisler L, Penninga L. Leiomyosarcoma of the abdomen and retroperitoneum; a systematic review. Front Surg 2024; 11:1375483. [PMID: 39086921 PMCID: PMC11288885 DOI: 10.3389/fsurg.2024.1375483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Background Intraabdominal and retroperitoneal leiomyosarcomas are rare cancers, which cause significant morbidity and mortality. Symptoms, treatment and follow up differs from other cancers, and proper diagnosis and treatment of intraabdominal and retroperitoneal leiomyosarcomas is of utmost importance. We performed a systematic review to collect and summarize available evidence for diagnosis and treatment for these tumours. Methods We performed a systematic literature search of Pubmed from the earliest entry possible, until January 2021. Our search phrase was (((((colon) OR (rectum)) OR (intestine)) OR (abdomen)) OR (retroperitoneum)) AND (leiomyosarcoma). All hits were evaluated by two of the authors. Results Our predefined search identified 1983 hits, we selected 218 hits and retrieved full-text copies of these. 144 studies were included in the review. Discussion This review summarizes the current knowledge and evidence on non-uterine abdominal and retroperitoneal leiomyosarcomas. The review has revealed a lack of high-quality evidence, and randomized clinical trials. There is a great need for more substantial and high-quality research in the area of leiomyosarcomas of the abdomen and retroperitoneum. Systematic Review Registration PROSPERO, identifier, CRD42023480527.
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Affiliation(s)
- Mari Nanna Øines
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Louise Preisler
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Luit Penninga
- Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Almeida AM, Lima L, Martins T. Understanding quality of life's challenges in sarcoma patients: A mixed-methods study. Eur J Oncol Nurs 2024; 70:102585. [PMID: 38631125 DOI: 10.1016/j.ejon.2024.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Sarcoma, a highly aggressive form of cancer, profoundly affects patients both physically and psychologically. This study aimed to assess sarcoma patients' health-related quality of life and explore their experiences of living with the disease and their specific care requirements. METHODS This research employed a convergent parallel mixed-methods design. Fifty-two sarcoma patients completed the European Portuguese version of the EORTC QLQ-C30 questionnaire, and seven of them participated in semi-structured interviews. Descriptive measures, Cronbach alpha for internal consistency, t-teste-Anova and stepwise regression were employed in the quantitative analysis. Qualitative data was analysed thematically. RESULTS The most affected Quality of life (QoL) dimensions were role functioning and global health, areas of functioning that were also described as impacted in patients' experiences. Symptoms like insomnia, pain, and fatigue were frequently reported. Symptoms such as fatigue, pain, and financial difficulty explain QoL variance. No significant differences in QoL were found according to the different forms of treatment. Analysis of the interviews revealed three overarching themes: (1) disruption of daily life, (2) adaptation to life with sarcoma, and (3) the demand for more personalized care, allowing to gain a deeper understanding of living with sarcoma. CONCLUSION The results underscore the significance of delivering care that enhances the quality of life for sarcoma patients, addressing both their physical and psychosocial needs, and providing personalized support throughout all stages of the disease.
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Affiliation(s)
- Ana Maria Almeida
- ICBAS/UP - Institute for the Biomedical Sciences Abel Salazar / Porto University, Porto, Portugal; Francisco Gentil Portuguese Institute for Oncology of Porto, Portugal.
| | - Lígia Lima
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
| | - Teresa Martins
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
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Treatment Pathways and Prognosis in Advanced Sarcoma with Peritoneal Sarcomatosis. Cancers (Basel) 2023; 15:cancers15041340. [PMID: 36831681 PMCID: PMC9954769 DOI: 10.3390/cancers15041340] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Sarcomas represent a heterogeneous group of mesenchymal malignancies that most commonly occur in the extremities, retroperitoneum, and head and neck. Intra-abdominal manifestations are rare and prove particularly difficult to treat when peritoneal sarcomatosis is present. Because of the overall poor prognosis of the disease, a tailored approach to surgical management is essential to achieve satisfactory outcomes with limited morbidity. We present the perioperative and long-term outcomes of 19 cases of sarcoma with peritoneal sarcomatosis treated surgically at our hospital. Treatment pathways were reviewed and clinical follow-up was performed. Patient characteristics, medical history, tumor subtype, surgical approach, hospital stay, complications, follow-up, and overall survival (OS) were assessed. Our patients were 9 women and 10 men with a median age of 45.9 years (18-88) and a median survival of 30 months (0-200). In most cases, peritoneal sarcomatosis was either discovered during surgery or the procedure was performed with palliative intent from the beginning. The surgical approach in these cases is very heterogeneous and should consider a variety of factors to tailor an approach for each patient. Sharing our experiences will help to increase knowledge about this rare disease and provide insight into the management of future cases.
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Mitchinson L, Chu C, Bruun A, Sisk AR, Armstrong M, Vindrola-Padros C, Kupeli N, Candy B, Stone P. How best to capture the impact of complementary therapies in palliative care: A systematic review to identify and assess the appropriateness and validity of multi-domain tools. Palliat Med 2022; 36:1320-1335. [PMID: 36071641 PMCID: PMC9606018 DOI: 10.1177/02692163221122955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their effectiveness from clinical trials is inconclusive. This may be because trials are limited by use of inappropriate outcome measures. AIMS To identify tools which capture the impact of massage, reflexology and aromatherapy in people with advanced disease. We (1) identified multi-domain tools used to evaluate these therapies in populations with any chronic health condition and (2) assessed whether tools were valid and psychometrically robust in populations with advanced disease. DESIGN A two-stage systematic review was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines (PROSPERO: CRD42020161199). DATA SOURCES Six databases were searched (August 2021). Study methodological quality, tool psychometric properties and evidence quality were assessed. A global comparison score was generated. RESULTS Stage 1: 66 trials using 40 different multi-domain tools were identified. Stage 2: Of these tools, we identified papers for seven tools regarding development or validation in advanced disease populations. The majority of psychometric data were inconsistent or inconclusive. Data were mostly of low quality due to methodological issues. CONCLUSION Of the tools identified, 'Functional Assessment of Cancer Therapy - General' appears to be the most suitable alternative tool against COMSIN criteria, for trials of massage, reflexology and aromatherapy in palliative care. Further tool validation is required before firm recommendations can be made. Co-development of a core outcome set could ensure relevant domains are assessed.
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Affiliation(s)
- Lucy Mitchinson
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Christina Chu
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Andrea Bruun
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Ali-Rose Sisk
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Megan Armstrong
- Primary Care and Population Health, University College London, London, UK
| | - Cecilia Vindrola-Padros
- Department of Targeted Intervention and Rapid Research, Evaluation and Appraisal Lab (RREAL), University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, University College London, London, UK
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5
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Younger E, Jones RL, den Hollander D, Soomers VLMN, Desar IME, Benson C, Young RJ, Oosten AW, de Haan JJ, Miah A, Zaidi S, Gelderblom H, Steeghs N, Husson O, van der Graaf WTA. Priorities and preferences of advanced soft tissue sarcoma patients starting palliative chemotherapy: baseline results from the HOLISTIC study. ESMO Open 2021; 6:100258. [PMID: 34509803 PMCID: PMC8441156 DOI: 10.1016/j.esmoop.2021.100258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/19/2021] [Accepted: 08/04/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Palliative chemotherapy is the principal treatment of patients with advanced soft tissue sarcomas (STS); however prognosis is limited (median overall survival 12-19 months). In this setting, patient values and priorities are central to personalised treatment decisions. PATIENTS AND METHODS The prospective HOLISTIC study was conducted in the UK and the Netherlands assessing health-related quality of life in STS patients receiving palliative chemotherapy. Participants completed a questionnaire before starting chemotherapy, including attitudes towards quality of life (QoL) versus length of life (LoL), decisional control preferences, and decisional conflict. Chi-square and Fisher's exact tests were used to evaluate associations between patient characteristics and preferences. RESULTS One hundred and thirty-seven patients with advanced STS participated (UK: n = 72, the Netherlands: n = 65). Median age was 62 (27-79) years. Preference for extended LoL (n = 66, 48%) was slightly more common than preference for QoL (n = 56, 41%); 12 patients (9%) valued LoL and QoL equally (missing: n = 3). Younger patients (age <40 years) prioritised LoL, whereas two-thirds of older patients (aged ≥65 years) felt that QoL was equally or more important than LoL (P = 0.020). Decisional conflict was most common in patients who prioritised QoL (P = 0.024). Most patients preferred an active (n = 45, 33%) or collaborative (n = 59, 44%) role in treatment decisions. Gender, performance status, and country were significantly associated with preferred role. Concordance between preferred and actual role in chemotherapy decision was high (n = 104, 76%). CONCLUSIONS Heterogeneous priorities and preferences among advanced STS patients support personalised decisions about palliative treatment. Considering individual differences during treatment discussions may enhance communication and optimise patient-centred care.
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Affiliation(s)
- E Younger
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - R L Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - D den Hollander
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - V L M N Soomers
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - I M E Desar
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - C Benson
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - R J Young
- Academic Unit of Clinical Oncology, The University of Sheffield, Sheffield, UK
| | - A W Oosten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J J de Haan
- Department of Medical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - A Miah
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - S Zaidi
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - N Steeghs
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - O Husson
- Division of Clinical Studies, Institute of Cancer Research, London, UK; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - W T A van der Graaf
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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6
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Stover AM, Kurtzman R, Walker Bissram J, Jansen J, Carr P, Atkinson T, Ellis CT, Freeman AT, Turner K, Basch EM. Stakeholder Perceptions of Key Aspects of High-Quality Cancer Care to Assess with Patient Reported Outcome Measures: A Systematic Review. Cancers (Basel) 2021; 13:cancers13143628. [PMID: 34298841 PMCID: PMC8306432 DOI: 10.3390/cancers13143628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/02/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary We conducted a review to identify important symptoms reported by patients on questionnaires (e.g., pain) that can be used to compare cancer centers on how well they provide care. For example, cancer centers could be compared on the percentage of patients with controlled pain after adjusting for demographic and clinical characteristics. Standard review methods were used to identify studies through August 2020. Searches generated 1813 articles and 1779 were coded as not relevant. The remaining 34 studies showed that patients, caregivers, clinicians, and healthcare administrators identify psychosocial care (e.g., distress) and symptom management as critical parts of high-quality care. Patients and caregivers also perceive that maintaining physical function and daily activities are important. Clinicians and healthcare administrators perceive control of specific symptoms to be important (e.g., pain, poor sleep, diarrhea). Results were used to inform testing of symptom questionnaires to compare the quality of care provided by six cancer centers. Abstract Performance measurement is the process of collecting, analyzing, and reporting standardized measures of clinical performance that can be compared across practices to evaluate how well care was provided. We conducted a systematic review to identify stakeholder perceptions of key symptoms and health domains to test as patient-reported performance measures in oncology. Stakeholders included cancer patients, caregivers, clinicians, and healthcare administrators. Standard review methodology was used, consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). MEDLINE/PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies through August 2020. Four coders independently reviewed entries and conflicts were resolved by a fifth coder. Efficacy and effectiveness studies, and studies focused exclusively on patient experiences of care (e.g., communication skills of providers) were excluded. Searches generated 1813 articles and 1779 were coded as not relevant, leaving 34 international articles for extraction. Patients, caregivers, clinicians, and healthcare administrators prioritize psychosocial care (e.g., distress) and symptom management for patient-reported performance measures. Patients and caregivers also perceive that maintaining physical function and daily activities are critical. Clinicians and administrators perceive control of specific symptoms to be critical (gastrointestinal symptoms, pain, poor sleep). Results were used to inform testing at six US cancer centers.
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Affiliation(s)
- Angela M. Stover
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC 27599, USA;
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
- Correspondence:
| | - Rachel Kurtzman
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC 27599, USA;
| | | | - Jennifer Jansen
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
| | - Philip Carr
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
| | - Thomas Atkinson
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - C. Tyler Ellis
- Department of Surgery, University of Louisville Health, Louisville, KY 40202, USA;
| | | | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Ethan M. Basch
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC 27599, USA;
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
- Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA;
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Komatsu S, Okamoto M, Shiba S, Kaminuma T, Okazaki S, Kiyohara H, Yanagawa T, Nakano T, Ohno T. Prospective Evaluation of Quality of Life and Functional Outcomes after Carbon Ion Radiotherapy for Inoperable Bone and Soft Tissue Sarcomas. Cancers (Basel) 2021; 13:cancers13112591. [PMID: 34070569 PMCID: PMC8199366 DOI: 10.3390/cancers13112591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Quality of life (QOL) and functional outcomes in patients with inoperable bone and soft tissue sarcoma treated with definitive carbon-ion radiotherapy (CIRT) were prospectively investigated. CIRT showed favorable clinical efficacy and safety, maintaining the physical component of QOL and functional outcomes, and improving the mental component of QOL. The physical component of QOL was positively correlated with functional outcomes. Poor performance status at diagnosis and female gender were independent predictors of the physical component of QOL and functional outcomes after CIRT. Abstract Carbon-ion radiotherapy (CIRT) represents a definitive treatment for inoperable bone and soft tissue sarcoma (BSTS). This prospective study analyzed 61 patients with inoperable BSTS who were treated with CIRT to evaluate QOL, functional outcomes, and predictive factors in patients with inoperable BSTS treated with definitive CIRT. The Musculoskeletal Tumor Society (MSTS) scoring system and the Short Form (SF)-8 questionnaire were completed before and at 1, 3, 6, 12, and 24 months after CIRT. The median follow-up period was 38 months. The main site of primary disease was the pelvis (70.5%), and the most common pathologic diagnosis was chordoma (45.9%). The 3-year overall survival and local control rates were 87.8% and 83.8%, respectively. The MSTS score and physical component score (PCS) of SF-8 did not change significantly between the baseline and subsequent values. The mental component score of SF-8 significantly improved after CIRT. Multivariate analysis showed that the normalized MSTS and normalized PCS of SF-8 at the final follow-up were significantly affected by performance status at diagnosis and sex. CIRT showed clinical efficacy, preserving the physical component of QOL and functional outcomes and improving the mental component of QOL, suggesting its potential value for the treatment of patients with inoperable BSTS.
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Affiliation(s)
- Shuichiro Komatsu
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
| | - Masahiko Okamoto
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan
- Correspondence: ; Tel.: +81-283-22-5222
| | - Shintaro Shiba
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan
| | - Takuya Kaminuma
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan
| | - Shohei Okazaki
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan
| | - Hiroki Kiyohara
- Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, 389-1, Asakura-machi, Maebashi 371-0811, Gunma, Japan;
| | - Takashi Yanagawa
- Department of Orthopedic Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan;
| | - Takashi Nakano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1, Anagawa, Inage-ku, Chiba-shi 363-8555, Chiba, Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan; (S.K.); (S.S.); (T.K.); (S.O.); (T.N.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-15, Showa-machi, Maebashi 371-8511, Gunma, Japan
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Maggi G, Terrenato I, Giacomelli L, Bifano V, Gravili A, Faltyn W, Ferraresi V, Favale L, Petrongari MG, Salducca N, Vari S, Falcicchio C, Rossi B, Biagini R, Pugliese P. Symptoms and their implications on quality of life and psychological distress in sarcoma patients. Future Oncol 2021; 17:817-823. [PMID: 33508959 DOI: 10.2217/fon-2020-0572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate symptoms, their variation over time and their relationship with quality of life (QoL)/psychological distress in sarcoma patients, as few data regarding QoL and psychological distress in this set of patients are currently available. A total of 188 sarcoma patients from an Italian referral center were involved. Symptoms and financial difficulties were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire from the first treatment and over the follow-up period, up to 6 years. The authors found that patients with sarcoma experience several symptoms, especially fatigue and pain, which may dramatically worsen QoL and psychological distress. In conclusion, patients with sarcoma often experience fatigue, pain and financial difficulties, which negatively impacts QoL and psychological distress. To ameliorate overall QoL, proper control of symptoms is necessary.
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Affiliation(s)
- Gabriella Maggi
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Biostatistic Unit - Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luca Giacomelli
- Polistudium SRL, Milan, Italy.,Department of Surgical Sciences & Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Viviana Bifano
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandra Gravili
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Wioletta Faltyn
- Sarcoma Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Leonardo Favale
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Grazia Petrongari
- Deptartment of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Nicola Salducca
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Falcicchio
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Barbara Rossi
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Pugliese
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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9
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Brandes F, Striefler JK, Dörr A, Schmiester M, Märdian S, Koulaxouzidis G, Kaul D, Behzadi A, Thuss-Patience P, Ahn J, Pelzer U, Bullinger L, Flörcken A. Impact of a specialised palliative care intervention in patients with advanced soft tissue sarcoma - a single-centre retrospective analysis. BMC Palliat Care 2021; 20:16. [PMID: 33446180 PMCID: PMC7809873 DOI: 10.1186/s12904-020-00702-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soft tissue sarcomas (STS) account for less than 1% of all malignancies. Approximately 50% of the patients develop metastases with limited survival in the course of their disease. For those patients, palliative treatment aiming at symptom relief and improvement of quality of life is most important. However, data on symptom burden and palliative intervention are limited in STS patients. AIM Our study evaluates the effectiveness of a palliative care intervention on symptom relief and quality of life in STS patients. DESIGN/SETTING We retrospectively analysed 53 inpatient visits of 34 patients with advanced STS, admitted to our palliative care unit between 2012 and 2018. Symptom burden was measured with a standardised base assessment questionnaire at admission and discharge. RESULTS Median disease duration before admission was 24 months, 85% of patients had metastases. The predominant indication for admission was pain, weakness and fatigue. Palliative care intervention led to a significant reduction of pain: median NRS for acute pain was reduced from 3 to 1 (p < 0.001), pain within the last 24 h from 5 to 2 (p < 0.001) and of the median MIDOS symptom score: 18 to 13 (p < 0.001). Also, the median stress level, according to the distress thermometer, was reduced significantly: 7.5 to 5 (p = 0.027). CONCLUSIONS Our data underline that specialised palliative care intervention leads to significant symptom relief in patients with advanced STS. Further efforts should aim for an early integration of palliative care in these patients focusing primarily on the identification of subjects at high risk for severe symptomatic disease.
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Affiliation(s)
- F Brandes
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - J K Striefler
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Dörr
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Schmiester
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Märdian
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Centre for Musculoskeletal Surgery, Campus Virchow-Klinikum, Berlin, Germany
| | - G Koulaxouzidis
- Department of Surgery, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Plastic and Reconstructive Surgery, Berlin, Germany
| | - D Kaul
- Department of Radiation Oncology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Behzadi
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - P Thuss-Patience
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Ahn
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Pelzer
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - L Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
- German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
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The Health-Related Quality of Life of Sarcoma Patients and Survivors in Germany-Cross-Sectional Results of a Nationwide Observational Study (PROSa). Cancers (Basel) 2020; 12:cancers12123590. [PMID: 33266287 PMCID: PMC7759994 DOI: 10.3390/cancers12123590] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 01/17/2023] Open
Abstract
Simple Summary Sarcomas are a rare cancer with many different subtypes. They can occur anywhere in the body and are treated in a multi-disciplinary manner. Large studies on the quality of life of sarcoma patients are rare, so little is known about how patients are doing compared to the general population and which groups of sarcoma patients are particularly affected by quality of life limitations. We assessed the quality of life of 1113 sarcoma patients from Germany. The majority were particularly restricted in their emotional functioning, physical functioning, and the exercise of everyday demands (role function). Many of them experienced pain (56%) and fatigue (51%). We found that patients with leg or bone sarcomas were especially affected by quality of life limitations. We also found that patients who received a retirement pension were less affected by quality of life restrictions than patients who had not retired. Abstract Sarcomas are rare cancers with high heterogeneity in terms of type, location, and treatment. The health-related quality of life (HRQoL) of sarcoma patients has rarely been investigated and is the subject of this analysis. Adult sarcoma patients and survivors were assessed between September 2017 and February 2019 in 39 study centers in Germany using standardized, validated questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)). Associated factors were analyzed exploratively using multivariable linear regressions. Among 1113 patients, clinically important limitations and symptoms were most pronounced in emotional (63%, 95% CI 60–66%), physical (60%, 95% CI 57–62%), role functioning (51%, 95% CI 48–54%), and pain (56%, 95% CI 53–59%) and fatigue (51%, 95% CI 48–54%). HRQoL differed between tumor locations with lower extremities performing the worst and sarcoma types with bone sarcoma types being most affected. Additionally, female gender, higher age, lower socioeconomic status, recurrent disease, not being in retirement, comorbidities, and being in treatment were associated with lower HRQoL. Sarcoma patients are severely restricted in their HRQoL, especially in functioning scales. The heterogeneity of sarcomas with regard to type and location is reflected in HRQoL outcomes. During treatment and follow-up, close attention has to be paid to the reintegration of the patients into daily life as well as to their physical abilities and emotional distress.
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