ABSTRACT
Background: Sarcomas are extremely rare and disabling tumours causing physical impairments as well as psychological issues. The Health-related quality of life (HRQoL) in these patients (pts) is impaired as a consequence of their illness and its treatments. It is widely demonstrated the harmful impact of covid19 pandemic and its effects on the HRQoL of the general population and especially on cancer pts. We investigated this important aspect in sarcoma pts. Material (patients) and Methods: We performed a retrospective observational study including pts with diagnosis of soft tissue (STS) and bone sarcoma (BS) referred to Regina Elena National Cancer Institute in Rome and with histological diagnosis obtained during the year preceding (Control group-Ctg) or following (Covid group-Covg) the start of covid19 lockdown in Italy (March 9th 2020). Patients were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), with scores analysed as continuous scales, and with the Distress Thermometer (DT), where the pts were accounted for as having low/ absent (score 0-4) or high distress (5-10). Result(s): We enrolled a total of 115 pts, 76 in the Ctg and 39 in the Covg;43 women and 72 men. Median age was 55 years (range 94-21). In the Ctg and in the Covg respectively, the most common diagnosis was STS (N=52 vs 27) followed by BS (N=24 vs 12). Most pts had a localized disease at diagnosis (N=64 vs 34) and only 17 (N=12 vs 5) had distant metastasis. The first treatment received was surgery in 75 pts (N=52 vs 23), chemotherapy in 30 pts (N=18 vs 12), concomitant chemo-radiotherapy in 4 pts (N=3 vs 1), and 6 pts (N=3 vs 3) had a follow-up strategy. In the Covg, compared with the Ctg, we found a decline in Social functioning (average score (mu)=81,64;SD=30,54 vs 91,38;SD=16,24 respectively;p=0,027) as well as an increase in financial difficulties (mu=11,95;SD=22,31 vs 3,93;SD=13,29;p=0,017) and increased nausea (mu=5,13;SD=13,31 vs 1,12;SD=4,24;p=0,018). We also found a higher rate of patients with emotional distress in the Covg (50% vs 71,8% p=0,025). Worsening, although not statistically significant, was observed in almost all questionnaire domains. Conclusion(s): Our study suggests that the covid19 pandemic had a detrimental effect on HRQoL in sarcoma patients. This study makes an effort on the strong need of improvement psychological support for both emotional and physical effects in our pts.