Quality of life of sarcoma patients from diagnosis to treatments: Predictors and longitudinal trajectories

Paredes, Tiago; Pereira, Marco; Moreira, Helena; Simões, Mário R.; Canavarro, Maria Cristina

doi:10.1016/j.ejon.2011.01.001

Cited by 34 publications

(57 citation statements)

References 43 publications

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“…While most studies reported lower HRQoL outcome for patients with sarcoma compared with the general population, one study reported that patients with lower limb STSs treated with TM‐ILP reported higher HRQoL outcome . This, and other results, may be partially explained by the response shift theory.…”

Section: Discussionmentioning

confidence: 99%

“…Four studies reported HRQoL data from patients at both diagnostic and treatment phases. [39][40][41][42] Patients with sarcoma Compared with the general population, patients with sarcoma reported lower mean scores on all HRQoL scales, resulting in a lower mean global health score. 39 Compared with pretreatment scores, patients with sarcoma treated with radiotherapy and/or chemotherapy reported lower physical functioning, and more fatigue, nausea/vomiting, appetite loss, but less pain and a higher overall HRQoL score.…”

Section: At Diagnosis and Treatmentmentioning

confidence: 99%

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Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

et al. 2019

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Objective Health‐related quality of life (HRQoL), psychosocial distress, and unmet health needs are important patient‐reported outcomes (PROs) for patients with sarcoma treated with curative intent. Syntheses of data on these PROs in patients with sarcoma are limited. Methods A systematic review of peer‐reviewed literature published between 2007 and 2017 was conducted using five databases, guided by the PRISMA and Cochrane reporting guidelines. Results Of 7240 articles identified, 31 were included in this review. Compared with healthy individuals, patients with sarcoma frequently scored lower in physical and psychological HRQoL domains and experienced higher rates of self‐image issues, depression, and suicide. However, outcomes for patients with sarcoma were relatively comparable to those with other malignancies. Anxiety symptoms were more common in the diagnosis phase, while depressive symptoms were more common in the treatment phase. Patients who are older, female, and socially isolated often reported lower HRQoL. As a sarcoma‐specific HRQoL instrument is not available, and all studies have used generic instruments, key issues may have been omitted. Conclusion There are few studies reporting data for HRQoL, psychosocial issues, or unmet health needs in this population. A sarcoma‐specific HRQoL instrument is needed to accurately describe outcomes in this population. There is a need for further qualitative research to conceptualise the HRQoL issues relevant to this population, against which to map existing HRQoL instruments and guide adaptation or creation of a new instrument.

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Section: Discussionmentioning

confidence: 99%

Section: At Diagnosis and Treatmentmentioning

confidence: 99%

Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

et al. 2019

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“…Hence, these patients often suffer from debilitating disease-or treatment-related adverse effects and symptom burden [2]. Numerous studies have suggested that patients with sarcoma suffer from poorer health-related quality of life (HRQoL) at diagnosis and during treatment [3][4][5]. This is attributed to decreased physical and cognitive functioning, disease interference in family life, social and leisure activities, and an intense experience of disease-and treatment-related symptoms.…”

Section: Introductionmentioning

confidence: 99%

Symptom burden and medication use in adult sarcoma patients

Chan

Lim

et al. 2014

Support Care Cancer

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Purpose Limited data are available on how symptom burden affects health-related quality of life (HRQoL) in patients with sarcoma. This study aims to describe the symptom burden, HRQoL, and medication use in adult sarcoma patients. Methods A single-center, cross-sectional study was conducted, and 79 patients were evaluated using three tools: the Rotterdam Symptom Checklist (RSCL), the Beck Anxiety Inventory (BAI), and the Functional Assessment of Cancer Therapy scale-General (FACT-G). Patients' demographic and clinical information, medication history, and use of concomitant medications were recorded. The proportion of patients with clinically significant RSCL score for a particular symptom was compared with the percentage of patients receiving medication for that symptom. Results The mean age was 57.3±15.2 years, with majority of the patients diagnosed with stromal tumor (46.8 %), leiomyosarcoma (15.2 %), and liposarcoma (10.1 %). The most prevalent physical symptoms experienced were tiredness (2.38±1.00), lack of energy (2.04±1.02), and difficulty sleeping (2.00±1.15). The most common psychological symptoms experienced were irritability (1.92±1.01), worrying (1.86±0.90), and anxiety (1.68±0.74). Few (6.3 %) patients received hypnotics while 33.0 % of patients reported difficulty sleeping. A proportion of patients (27.9 %) reported experiencing lack of appetite with only 1.3 % received appetite stimulants.Conclusion Adult sarcoma patients experience significant physiological and psychological symptom burden, which has a strong negative impact on HRQoL, with a number of physiological symptoms undertreated with pharmacotherapy.

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“…Surgeons are often faced with situations whereby they have to strike a balance between optimal oncologic outcomes and limb function [25]. Although an amputation is sometimes the only way to achieve a margin negative resection, we know that even with an amputation and good local control, ultimately there is not a significant survival benefit [7,26]. Regional therapy with ILI is an attractive and acceptable alternative therapy for disease control and limb preservation in patients with unresectable locally advanced or recurrent soft tissue sarcomas of the extremity that are otherwise facing an amputation due to no other therapeutic options available [27].…”

Section: Discussionmentioning

confidence: 99%

“…Limb preservation for locally advanced sarcoma often requires radical resection and reconstruction which may result in significant morbidity, disfigurement, loss of function and compromised quality of life [7-9]. Although several studies have shown response rates in the range of 62-91% with the use of hyperthermic isolated limb perfusions (HILP) for soft tissue sarcomas of the extremity, only a few small studies using isolated limb infusion (ILI) (a well established treatment modality for recurrent melanoma on the extremities) have been described [10-19].…”

Section: Introductionmentioning

confidence: 99%

The use of isolated limb infusion in limb threatening extremity sarcomas

Vohra

Turaga

Gonzalez

et al. 2012

International Journal of Hyperthermia

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Background Locally advanced, limb threatening soft tissue sarcomas (STS) pose a significant treatment challenge. We report our experience using isolated limb infusion (ILI) in patients with unresectable extremity STS. Methods Twenty-two patients with extremity STS underwent 26 ILIs with melphalan and dactinomycin. Patient characteristics, intra-operative parameters and toxicity were recorded. Outcome measures included limb-salvage and in-field response rates. Results Of the 19 lower and 7 upper extremity ILIs, Wieberdink grade III toxicity or less was observed in all. Median follow up was 11 months. Seventeen patients were evaluable at 3 months post ILI with an overall response rate of 42%. Four (24%) had complete response (CR), 3 (18%) partial response (PR), 3 (18%) stable disease (SD) and 7 (41%) progressive disease (PD). Twelve of 17 (71%) underwent successful limb preservation at a median of 9 months post ILI. Two (12%) were downstaged to resectable disease and remain NED after surgery at 30 and 22 months post ILI. Conclusions ILI is an attractive modality that provides regional disease control and limb preservation in patients with limb threatening sarcoma. Although short term results appear encouraging, long term follow up is needed to fully assess the role of ILI in unresectable extremity STS.

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Quality of life of sarcoma patients from diagnosis to treatments: Predictors and longitudinal trajectories

Cited by 34 publications

References 43 publications

Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

Health‐related quality of life, psychosocial functioning, and unmet health needs in patients with sarcoma: A systematic review

Symptom burden and medication use in adult sarcoma patients

The use of isolated limb infusion in limb threatening extremity sarcomas

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