The age-related impact of surviving sarcoma on health-related quality of life: data from the SURVSARC study

C Drabbe,W.T.A Van Der Graaf,B.H De Rooij,D.J Grünhagen,V.L.M.N Soomers,M.A.J Van De Sande,L.B Been,K.B.M.I Keymeulen,I.C.M Van Der Geest,W.J Van Houdt,O Husson

doi:10.1016/j.esmoop.2021.100047

Abstract

BackgroundHealth-related quality of life (HRQoL) data of sarcoma survivors are scarce and the impact of age remains unclear. The aims of this population-based study were to (i) compare HRQoL scores amongst three age-groups [adolescents and young adults (AYA, aged 18-39 years), older adults (OA, aged 40-69 years) and elderly (aged ≥70 years)]; (ii) compare HRQoL of each sarcoma survivor age group with an age- and sex-matched normative population sample; (iii) determine factors associated with low HRQoL per age group.MethodsDutch sarcoma survivors, who were 2-10 years after diagnosis, were invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions questionnaire on HRQoL.ResultsIn total, 1099 survivors (58% response rate) completed the questionnaire: 186 AYAs, 748 OAs and 165 elderly. The median time since diagnosis for all patients was 5.2 years. Bone sarcomas were seen in 41% of AYAs, 22% of OAs and in 16% of elderly survivors (P < 0.01). AYA and OA survivors reported statistically significant and clinically meaningful worse physical, role, cognitive, emotional and social functioning compared with a matched norm population, which was not the case for elderly survivors. AYAs reported significantly worse scores on emotional and cognitive functioning compared with OA and elderly survivors. Malignant peripheral nerve sheath tumour, osteosarcoma and chordoma were the subtypes of which survivors reported the lowest HRQoL scores in comparison with the norm. For all age groups, chemotherapy, having a bone sarcoma and having comorbidities were most frequently associated with low scores on HRQoL subscales, whereas a shorter time since diagnosis was not.ConclusionIn this nationwide sarcoma survivorship study, the disease and its treatment had relatively more impact on the HRQoL of AYA and OA survivors than on elderly survivors. These results emphasise the need for personalised follow-up care that not only includes risk-adjusted care related to disease relapse, but also age-adjusted care.

Highlights

Sarcomas are rare tumours originating from mesenchymal stem cells and account for approximately 1% of adult malignancies
No statistically significant differences were observed for soft tissue sarcomas (STS) versus bone sarcomas (BS) between responders and non-responders, stratified by age group
Seen, BS were most often diagnosed in AYAs (41%), in OAs (22%) and least often in elderly survivors (16%)

Summary

Introduction

Sarcomas are rare tumours originating from mesenchymal stem cells and account for approximately 1% of adult malignancies. Health-related quality of life (HRQoL) data of sarcoma survivors are scarce and the impact of age remains unclear The aims of this population-based study were to (i) compare HRQoL scores amongst three age-groups [adolescents and young adults (AYA, aged 18-39 years), older adults (OA, aged 40-69 years) and elderly (aged !70 years)]; (ii) compare HRQoL of each sarcoma survivor age group with an age- and sex-matched normative population sample; (iii) determine factors associated with low HRQoL per age group. Conclusion: In this nationwide sarcoma survivorship study, the disease and its treatment had relatively more impact on the HRQoL of AYA and OA survivors than on elderly survivors These results emphasise the need for personalised followup care that includes risk-adjusted care related to disease relapse, and age-adjusted care.

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