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Onesti CE, Vari S, Minghelli D, Nardozza F, Rossi B, Sperati F, Checcucci E, Faltyn W, Cercato MC, Cosimati A, Salvatori F, Biagini R, Ciliberto G, Ferraresi V, Maggi G. Quality of life and emotional distress in sarcoma patients diagnosed during COVID-19 pandemic: a supplementary analysis from the SarCorD study. Front Psychol 2023; 14:1078992. [PMID: 37333608 PMCID: PMC10273400 DOI: 10.3389/fpsyg.2023.1078992] [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: 11/19/2022] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background The COVID-19 outbreak had a negative psychological impact on cancer patients. In this study, we analyzed emotional distress and quality of life in patients diagnosed with sarcoma during the first year of the pandemic compared to the previous year. Methods We retrospectively enrolled patients with soft tissue, bone sarcoma, and aggressive benign musculoskeletal diseases diagnosed during the pandemic (COVID group) or the year before (control group) at the IRCCS Regina Elena National Cancer Institute in Rome. Patients who had undergone a psychological assessment with the EORTC QLQ-C30 and the Distress Thermometer at diagnosis were included in the final analysis. We analyzed whether there is a difference in the various domains of quality of life between the two groups and whether there are changes over time in each group. Results We enrolled 114 patients (72 control group; 42 COVID group), affected by soft tissue (64%), bone sarcoma (29%), and aggressive benign musculoskeletal diseases (7%). We did not observe significant differences in the health-related quality of life domains in the control and COVID groups, except for the financial domain (p = 0.039), with 9.7% vs. 23.8% of patients with a score > 0 in the control and COVID groups, respectively. We observed emotional distress at diagnosis in 48.6% of patients in the control group vs. 69.0% in the COVID group (p = 0.034). In the control group, we observed an improvement in physical function (p = 0.043) and in QoL (p = 0.022), while in the COVID group, we observed a deterioration in role function (p = 0.044) during follow-up. In the COVID group, 22.2% of patients were concerned about COVID-19, 61.1% by tumor, 91.1% stated that the pandemic worsened their subjective perception of cancer, and 19.4% perceived that their quality of care had worsened. Conclusion We observed a higher level of distress among patients diagnosed during the pandemic compared to the year before, probably due to the increased concern for both infection and cancer, the worsened perception of health status, and the perception of a poorer quality of health care.
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Affiliation(s)
- Concetta Elisa Onesti
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Denise Minghelli
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Nardozza
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Barbara Rossi
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Sperati
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Elisa Checcucci
- Epidemiology and Tumor Registry Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Wioletta Faltyn
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Cecilia Cercato
- Digital Library “R. Maceratini”, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonella Cosimati
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- University of Rome “Sapienza”, Rome, Italy
| | - Francesca Salvatori
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- University of Rome “Sapienza”, Rome, Italy
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gabriella Maggi
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Bone sarcoma follow-up; a nationwide analysis of oncological events after initial treatment. J Bone Oncol 2022; 38:100466. [PMID: 36578650 PMCID: PMC9791116 DOI: 10.1016/j.jbo.2022.100466] [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: 09/26/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Aim Follow-up strategies for high-grade bone sarcomas have been optimized to facilitate early detection of local recurrence and distant metastasis. The ideology is that early detection enables early treatment presuming better survival. However, the clinical value for each individual patient remains questionable. This study aims to evaluate oncological events after initial treatment in order to assess current follow-up strategies for high-grade bone sarcomas in the Netherlands. Patients and Methods A retrospective cohort study was conducted based on a national registry. All cases were retrieved from the Netherlands Cancer Registry. Our study consisted of 393 patients treated between 2007 and 2011 with complete follow-up data. Baseline characteristics were analysed for all entities. Local recurrence and distant metastasis was analysed along with overall survival for high-grade chondrosarcoma, high-grade osteosarcoma, Ewing sarcoma and chordoma. Results Median follow-up was 8,3 years for high-grade chondrosarcoma, 4,9 for high-grade osteosarcoma, 3,8 for Ewing sarcoma and 7,5 for chordoma. Median time to local recurrence and distant metastasis was 1,2 years for high-grade osteosarcoma and 1,5 years for Ewing sarcoma. For high-grade osteosarcoma with localized disease at presentation, 0.09 new distant metastatic events per patient per year were seen after five years of follow-up with 11,1 patients needed to follow-up for any event. Five-year overall survival was 60,0% for high-grade chondrosarcoma, 50,0% for high-grade osteosarcoma, 45,3% for Ewing sarcoma and 71,4% for chordoma. Conclusions This nationwide study shows a plateau in local recurrences and distant metastatic events after four years of treatment for patients with high-grade osteosarcoma and Ewing sarcoma. Due to a lack of reliable evidence however, we were not able to provide additional guidance on follow-up intervals and duration. Collaborative research with larger groups is needed in order to provide a solid scientific recommendation for follow-up in the heterogenous patient population with bone sarcoma.
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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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Keung EZ, Rajkot N, Torres KE, Somaiah N, Hunt KK, Feig BW, Scally CP, Ikoma N, Roland CL. Evaluating the Impact of Surveillance Follow-Up Intervals in Patients Following Resection of Primary Well-Differentiated Liposarcoma of the Retroperitoneum. Ann Surg Oncol 2020; 28:570-575. [PMID: 32409969 DOI: 10.1245/s10434-020-08582-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Resection of recurrent retroperitoneal well-differentiated liposarcoma (RP-WDLPS) is unlikely to result in cure. Thus, most clinicians delay surgery after recurrence until symptom intolerance or increasing rate of disease progression. The aim of this study was to determine whether longer surveillance intervals in this population would impact outcomes or delay treatment in those who recur. METHODS A retrospective review of patients with primary RP-WDLPS who underwent resection between April 1996 and April 2017 and surveillance at MDACC (n = 91) was performed. RESULTS Median age at diagnosis of primary RP-WDLPS was 61 years; median tumor size was 30 cm. Complete resection was achieved in 85 (93.4%) patients. Among patients who underwent complete resection, recurrence occurred in 53 (60.2%) with median time to recurrence of 27.0 months. Thirty-six (69.6%) of these patients underwent resection of recurrent disease at a median 40.2 months from primary tumor resection. Surveillance imaging at 4-month (vs 3-month) intervals would not have impacted recurrence management in 84 (95.5%) patients; imaging at 6-month (vs 3-month) intervals would not have impacted management of recurrence in 80 (90.9%). CONCLUSIONS Recurrence was common, often occurring beyond the early postoperative period following primary RP-WDLPS resection. More frequent surveillance imaging (q3-4 vs q6 months) in the first 2 years following primary RP-WDLPS resection may not significantly impact timing of surgery or systemic therapy for recurrence. If longer surveillance intervals were shown to be safe with equivalent outcomes in prospective studies, the resulting change in practice could lead to decreased anxiety and cost for patients and healthcare systems.
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Affiliation(s)
- Emily Z Keung
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Nikita Rajkot
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Keila E Torres
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Neeta Somaiah
- Department of Sarcoma Medical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Kelly K Hunt
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Barry W Feig
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Christopher P Scally
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Naruhiko Ikoma
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Christina L Roland
- Department of Surgical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA.
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