Characterizing the end-of-life period in young patients with sarcomas.

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11027 Background: There is a paucity of data surrounding the end-of life transition (EOLT) in young adult (YA) patients with sarcoma. Discussions surrounding prognosis, goals of care (GOC), hospice and death can be challenging in these patients as they may be at a particularly hopeful stage of their life. The purpose of this study is to better understand the EOLT in YA patients with sarcoma by determining the survival and number of lines of treatment at different periods in the disease course. In addition, the study aims to determine what impacts the decision to discontinue anti-cancer therapy. Methods: Fox Chase Cancer Center (FCCC) patients, 18-39 years old who died from sarcoma between January 2013 and December 2016 were included in this study. Patient demographics, tumor specific data, treatment and treatment decisions were collected from electronic medical records and retrospectively analyzed. Results: 38 FCCC patients who were diagnosed between the ages of 18-39 died between January 2013 and December 2016. Of these 21 patients were between the ages of 18-39 at the time of their death. Median age at death was 30 (range: 22-40). The most common histologies were Ewing Sarcoma, GIST (n = 3) and osteosarcoma, synovial sarcoma (n = 2). Median time from diagnosis of metastatic disease to death was 21.4 months. Median time from metastatic disease to discussion of GOC and hospice by any provider was 9.6 and 16.7 months respectively. The hospice discussion was held by the treating oncologist 87.5% (n = 16) of the time (outpatient 35.7% and inpatient 64.3%). 60% (n = 15) of patients/family selected hospice when it was originally presented to them (multi-organ failure, unarousable, paralysis). The hospice discussion was held at a median of 21 days prior to death and median time on hospice was 13 days (range: 1-63). Patients were treated a median of 54 days prior to their death (range: 6-1823). Median times on first, 2ndto last and last treatments were 273, 67 and 22.5 days respectively (P = 0.002). Conclusions: Focusing on this particular group of patients will generate benchmark data that can help counsel them about their specific expected survival and changes in clinical status as their disease progresses. We plan to compare this data with that of older patients.