Quality of life, fatigue, and pain in patients with progressive or recurrent bone and soft tissue sarcomas: an observational study

Abstract Objectives Quality of life (QoL), fatigue, and pain are poorly described in patients with recurrent or progressive bone and soft tissue sarcomas, whose treatment pathway is often longer and more complex. Previous studies have shown that patients with progressive sarcomas report lower overall QoL scores than those with stable disease. The aim of this study was to describe QoL, cancer-related fatigue, and pain perception in patients with progressive or recurrent malignant bone or soft tissue tumors, and to explore differences by tumor type and time-based outcome trajectories over a 24-month follow-up. Methods This prospective observational study enrolled patients with confirmed disease recurrence or progression between July 2019 and April 2021. QoL was assessed using the EORTC QLQ-C30, fatigue via the Brief Fatigue Inventory (BFI), and pain with the Numeric Rating Scale (NRS). Assessments were performed at baseline and at 6, 12, and 24 months. Linear mixed-effects regression models were used to analyze temporal trends and assess associations with age and tumor type. Results 42 patients were included (mean age 41.3 ± 15.5 years; 45.2 % female). No significant baseline differences were observed between tumor types. Pain and fatigue improved significantly over time. Global QoL declined markedly at 12 and 24 months, while functional and symptom-related QoL remained stable. Age was significantly associated with worse trajectories in pain and QoL, while tumor type was not. Conclusions Patients with recurrent or progressive sarcomas experience similar symptom burden regardless of tumor type. Pain and fatigue tend to improve over time, but global QoL declines. Age appears to be a relevant factor influencing symptom evolution and should be considered in designing supportive interventions.