Functional outcomes of bony sarcoma in adolescent and young adult patients: A systematic review.

Abstract

161 Background: Sarcomas are heterogeneous rare cancers, and while it affects 1% of all adult cancers, they affect 10-20% of Adolescents and Young Adults(AYAs). Sarcomas can be divided into soft tissue sarcomas(STS) and bony sarcomas(BS). The 5-year survival rates range between 50-60% but have remained stagnant. While the management of BS involves systemic treatment and morbid surgeries, functional outcomes and quality-of-life(QoL) have been largely overlooked. These changes are usually persistent and irreversible, with significant impact on mobility, function and body image. There are many facets of functional outcomes, including physical, social and psychological. These outcomes directly affect patients’ independence, self-confidence and future job endeavors, yet hardly any specific research has gone into it. Methods: A systematic review yielded 833relevant papers, but only 27was included for final analysis. Inclusion criteria included literature published in English, focused on AYAs 16-39 years, BS and papers assessing functional outcomes after treatment. We also included studies that investigated survivorship in pediatric BS, as these patients will transit into young adults who are childhood cancer survivors. Results: Outcomes of AYA are poorer in all aspects – physical function, social reintegration and psychological health. The heterogeneity among AYA patients, and large differences require individualized care based on stages of their personal development. There is greater adjustment required in AYAs due to higher physical, social and financial demands as they mature and aim to become independent. Current tools to assess HRQoL in AYAs are not standardized or validated in this age group. More research is required to identify long term outcomes post-treatment and into survivorship. Conclusions: AYAs have often been referred to as the ‘lost tribe’, with many of their needs overlooked. They are stricken with a cancer diagnosis during their prime and it is essential to manage them holistically to preserve and maximize their functional outcomes.