title: Variations of Surveillance Practice for Patients with Bone Sarcoma: A Survey of Australian Sarcoma Clinicians.
abstract: Introduction. After treatment, bone sarcoma patients carry a high chance of relapse and late effects from multimodal therapy. We hypothesize that significant variation in surveillance practice exists between pediatric medical oncology (PO) and nonpediatric medical oncology (NP) sarcoma disciplines.Methods. Australian sarcoma clinicians were approached to do a web based survey that assessed radiologic surveillance (RS) strategies, late toxicity assessment, and posttreatment psychosocial interventions. Results. In total, 51 clinicians responded. No differences were identified in local disease RS. In metastatic disease response assessment, 100% of POs (23/23) and 93% of NPs (24/26) conducted CT chest. However, this was more likely to occur for NPs in the context of a CT chest/abdomen/pelvis (NP: 10/26; PO: 1/23;p= 0.006). POs were more likely to use CXR for RS (p= 0.006). POs showed more prescriptive intensity in assessment of heart function (p= 0.001), hearing (p< 0.001), and fertility (p= 0.02). POs were more likely to deliver written information for health maintenance/treatment summary (p= 0.04). The majority of respondents described enquiring about psychosocial aspects of health (n= 33/37, 89%), but a routine formal psychosocial screen was only used by 23% (n= 6/26).Conclusion. There is high variability in bone sarcoma surveillance between PO and NP clinicians. Efforts to harmonize approaches would allow early and late effects recognition/intervention and facilitate improved patient care/transition and research.
authors.affiliation: Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Adolescent and Young Adult Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
authors.forename: Jeremy
authors.identifier: 0000-0002-4305-117X
authors.initials: J
authors.lastname: Lewin
authors.affiliation: Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Australasian Sarcoma Study Group, Melbourne, VIC, Australia.
authors.forename: Susie
authors.initials: S
authors.lastname: Bae
authors.affiliation: Australasian Sarcoma Study Group, Melbourne, VIC, Australia.
authors.forename: Jayesh
authors.initials: J
authors.lastname: Desai
authors.affiliation: Australian and New Zealand Children's Hematology/Oncology Group, Melbourne, VIC, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Strong
authors.affiliation: Australasian Sarcoma Study Group, Melbourne, VIC, Australia.
authors.forename: Denise
authors.initials: D
authors.lastname: Caruso
authors.affiliation: Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Howell
authors.affiliation: Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Herschtal
authors.affiliation: Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Sullivan
authors.affiliation: Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Orme