An analysis of palliative care in adolescents and young adults with soft tissue and bone sarcomas.
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BACKGROUND: Soft tissue and bone sarcomas affect adolescents and young adults and require intensive treatments despite overall poor prognoses. These factors seem to provide an indication for palliative care, a specialty committed to addressing physical and psychological suffering for patients with serious illnesses. AIM: Explore palliative care intervention in the adolescent and young adult sarcoma population and qualitatively analyze palliative care visits and medical oncology visits to propose a framework for collaboration. DESIGN: A quantitative retrospective review and directed content analysis of palliative care and medical oncology visits. SETTING/PARTICIPANTS: Single-center review of adolescent and young adult patients with soft tissue or bone sarcoma who died April 1, 2019-March 31, 2024, and directed content analysis of clinical documentation from 10 patients who received palliative care. RESULTS: Thirty-nine of 63 patients (62%) received palliative care. Median overall survival from advanced/metastatic diagnosis was 700 days for those with palliative care and 500 days for those without (95% CI: 0.84-2.33). Overall survival at 24 months from advanced/metastatic diagnosis was 43.6% for those with palliative care and 29.2% for those without, p = 0.38. Palliative care and medical oncology visits addressed physical symptoms, while end-of-life discussions were more common in palliative care visits. CONCLUSION: Adolescents and young adults with soft tissue and bone sarcomas may especially benefit from early engagement of palliative care both in trends toward improved overall survival and respect for end-of-life wishes. Future directions will be aimed at promoting early engagement through patient and provider education and optimization of referral patterns to identify vulnerable patients.