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Sarcoma
Volume 2011, Article ID 325189, 8 pages
http://dx.doi.org/10.1155/2011/325189
Research Article

Symptom Burden, Survival and Palliative Care in Advanced Soft Tissue Sarcoma

1Palliative Care Department, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK
2Division of Medicine, Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP, UK
3National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
4Sarcoma Unit, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK

Received 29 June 2011; Revised 16 August 2011; Accepted 31 August 2011

Academic Editor: Alessandro Gronchi

Copyright © 2011 Nicholas J. Gough et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The symptom burden and role of palliative care (PC) in patients with advanced soft tissue sarcoma (STS) are not well defined. Methods. This study retrospectively reviewed both symptoms and PC involvement in patients known to an STS referral centre who died in one calendar year. Results. 81 patients met inclusion criteria of which 27% had locally advanced disease and 73% metastases at initial referral. The median number of symptoms was slowly progressive ranging from 2 (range 0–5) before first-line chemotherapy ( 𝑛 = 5 0 ) to 3 (range 1–6) at the time of best supportive care (BSC) decision ( 𝑛 = 4 8 ). Pain and dyspnoea were the commonest symptoms. Median overall survival from BSC decision was 3.4 weeks. 88% had PC involvement (either hospital, community, or both) with median time from first PC referral to death of 16 (range 0–110) weeks. Conclusions. Patients with metastatic STS have a significant symptom burden which justifies early PC referral. Pain, including neuropathic pain, is a significant problem. Dyspnoea is common, progressive and appears to be undertreated. Time from BSC decision to death is short, and prospective studies are required to determine whether this is due to overtreatment or very rapid terminal disease progression.