204P Sarcoma representation and outcomes in molecular pan-cancer basket trials: A systematic landscape analysis of clinicaltrials.gov (2010–2025)

under sustained adversity, informed interpretation while avoiding individual clinical detail.Results: Three themes emerged.First, transitions from paediatric to adult services produce discontinuity, with no defined responsibility for long term follow up of childhood sarcoma survivors.Second, long term biomechanical changes and mobility-related uncertainty arise from the nature of childhood limb salvage and are not fully anticipated in standard adult medical or psychosocial care models, even when clinical care is appropriate.Third, national rare cancer strategies reference survivorship unevenly and do not consistently integrate psychosocial constructs central to long term adaptation, including identity reconstruction and meaning making.Conclusions: Long term osteosarcoma survivorship requires coordinated attention to functional, biomechanical and psychosocial needs across the life course.Recognising identity disruption, meaning making and lifelong mobility uncertainty within rare cancer frameworks may strengthen continuity of care and improve outcomes for adult survivors.