Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
ESMO Open. 2021 Feb;6(1):100047. doi: 10.1016/j.esmoop.2021.100047. Epub 2021 Jan 27.
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.
Dutch 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.
In 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.
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 follow-up care that not only includes risk-adjusted care related to disease relapse, but also age-adjusted care.
肉瘤幸存者的健康相关生活质量（HRQoL）数据稀缺，年龄的影响尚不清楚。本基于人群的研究旨在：（i）比较三个年龄组[青少年和年轻人（AYA，18-39 岁）、老年人（40-69 岁）和老年人（≥70 岁）]的 HRQoL 评分；（ii）比较每个肉瘤幸存者年龄组的 HRQoL 与年龄和性别匹配的正常人群样本；（iii）确定与每个年龄组的低 HRQoL 相关的因素。
诊断后 2-10 年的荷兰肉瘤幸存者被邀请完成欧洲癌症研究与治疗组织生活质量问卷核心 30 个问题问卷，以评估 HRQoL。
共有 1099 名幸存者（58%的应答率）完成了问卷：186 名 AYA，748 名 OA 和 165 名老年人。所有患者的中位诊断后时间为 5.2 年。骨肉瘤见于 41%的 AYA、22%的 OA 和 16%的老年幸存者（P<0.01）。AYA 和 OA 幸存者报告的身体、角色、认知、情感和社会功能明显且具有临床意义的下降，与匹配的正常人群相比，而老年幸存者则不然。与 OA 和老年幸存者相比，AYA 报告的情感和认知功能明显更差。恶性外周神经鞘瘤、骨肉瘤和脊索瘤是幸存者报告 HRQoL 评分最低的亚型。对于所有年龄组，化疗、患有骨肉瘤和合并症与 HRQoL 子量表评分较低最相关，而诊断后时间较短则不相关。
在这项全国性的肉瘤生存研究中，疾病及其治疗对 AYA 和 OA 幸存者的 HRQoL 影响相对较大，而对老年幸存者的影响较小。这些结果强调了需要个性化的随访护理，不仅包括与疾病复发相关的风险调整护理，还包括年龄调整护理。
