An analysis of palliative care in adolescents and young adults with soft tissue and bone sarcomas

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.