title: Symptom Burden in Advanced Soft-Tissue Sarcoma.
abstract: There is little information on symptom prevalence and severity in advanced soft-tissue sarcoma (STS). Understanding symptom burden will aid clinical consultations, clarify which symptom interventions are needed, and better define optimum timings of palliative and supportive care referrals.
  
  
  
  To describe symptom prevalence and severity in patients undergoing different treatment options for advanced STS: 1) first-line palliative chemotherapy (FLC), 2) active surveillance (AS) pre- and post-FLC, and 3) palliative care (PC) alone.
  
  
  
  Cross-sectional survey in one sarcoma center using the patient-reported Memorial Symptom Assessment Scale-Short Form (MSAS-SF). Symptom prevalence, severity, and MSAS-SF subscales were recorded before commencing a new treatment. Our results were compared with other MSAS-SF cancer and noncancer data.
  
  
  
  One-hundred and thirteen patients (mean age, 59 years) were recruited. Forty-two commenced FLC, 27 started AS pre-FLC, 24 AS post-FLC, and 20 PC alone. Median overall number of reported symptoms was 11 (range 1-31): which when stratified by treatment meant AS pre-FLC < AS post-FLC < FLC < PC alone (most symptomatic). The commonest physical symptoms were pain (77%; 95% CI 68-84), lack of energy (73%; CI 63-81) difficulty sleeping (56%; CI 46-65), feeling bloated (49%; CI 39-58), and dyspnea (49%; CI 39-58). Distress levels were commensurated with prevalence except for dyspnea, which was disproportionally less distressing. Psychological distress was moderate (mean MSAS-PSYCH: 1.39) but higher than comparative cancer data.
  
  
  
  Advanced STS patients have a clinically important symptom burden comparable to other cancers. Common symptoms should be screened and addressed appropriately, including timely PC involvement.
authors.affiliation: Royal Marsden and Royal Brompton Palliative Care Service, Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK. Electronic address: nicholas.gough@nhs.net.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Gough
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Kings College London, Cicely Saunders Institute, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Koffman
authors.affiliation: Royal Marsden and Royal Brompton Palliative Care Service, Royal Marsden NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Joy R
authors.initials: JR
authors.lastname: Ross
authors.affiliation: Royal Marsden and Royal Brompton Palliative Care Service, Royal Marsden NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Riley
authors.affiliation: The Institute of Cancer Research, London, UK; Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Judson
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D000071066:Patient Reported Outcome Measures; D015995:Prevalence; D012509:Sarcoma / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents
keywords: Advanced soft-tissue sarcoma; cancer; palliative care; prevalence study