(P 208) PSYCOLOGICAL ASSESSMENT IN A SAMPLE OF PATIENTS AT HOSPITAL CLÍNICO SAN CARLOS (MADRID), SARCOMA NATIONAL REFERRAL CENTRE IN SPAIN. HIGHLIGTHING THE NEED OF A GLOBAL STANDARIZED PSYCHOLOGICAL APPROACH

Objective: Sarcomas are rare cancers that originate in the bones or soft parts of the body. According to data collected by the Spanish Sarcoma Research Group (GEIS), this disease does not exceed 1% of all cancers diagnosed in Europe. Like any cancer diagnosis, sarcomas generate emotional impact and distress in patients and their families, affecting their quality of life in multiple dimensions.
Objectives: Evaluate the levels of anxiety, depression, quality of life, acceptance of the disease and their relationship with sociodemographic and clinical variables in patients with sarcoma.

Methods: Cross-sectional correlational descriptive design expecting to recruit 106 subjects (started on March 2023). Selection criteria: patients treated at Hospital Clinico San Carlos in Madrid, ≥ 18 years old, able to read and write in Spanish. Patients with a history of psychopathological disorder were excluded. Preliminary data of the 34 first enrolled patients was presented at CTOS 2023 annual meeting.
Independent variables studied: age, sex, marital status, employment and educational situation, type of sarcoma, stage and treatments received, evaluated by sociodemographic questionnaire. Symptoms of anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS: HAD-A and HADS-D), quality of life with the EORTC QLQ-C30, and the Illness Acceptance Questionnaire (alpha=0.84).

Results: At data cutoff on 7th of June 2024, 106 patients accepted to participate from March 2023, 50% of which were men; mean age 53.1 years (SD= 16.9); disease stage I: 25.2%; II: 31,8%; III: 19.6% stage IV: 23.4%.
The most relevant data were:
The level of acceptance of the disease was high: 29.40 (DT= 5.88), 95%CI= 27.80-31.01.
HADS-A= 5.96 (SD= 4.07) 95%CI=4.85-7.07) HADS-D= 4.03 (SD= 3.70), 95%CI=3.02- 5.04). 26.2% present clinical or subclinical anxiety symptoms and 26% clinical or subclinical depression symptoms.
The results in terms of quality of life were the following:
Global QLQ-C30: 67.75 (SD= 23.62) 95%CI=(61.29-57.39); QLQ-C30 Global F. Physics: 75.18 (DT=26.17) 95%CI= 66.04-82.32; QLQ-C30 F. Role: 70.06 (DT=33.39) 95%CI= 60.94- 79.17); QLQ-C30 F. Emotional: 70.83 (SD=26.24) ) 95%CI=63.67-77.99; QLQ-C30 F. Cognitive: 75.92 (DT=29.25) 95%CI=67.94-83.91); QLQ-C30 Social F.: 75 (DT=29.27) 95%CI=67.01-82.99). The symptoms with the highest means in the QLQ-C30 were Fatigue: 36 (DT=29.9) 95%CI=27.84 - 44.17); Pain: 29,62 (SD=28,16) 95%CI=21.94 -37.31); Insomnia 30.86 (SD=32.28) 95%CI=22.05-39.67).
The patients who received chemotherapy presented lower global acceptance of the disease (p=0.015), higher levels of depressive symptoms (p=0.023); scored worse in QLQ-C30 in Global (p=0.04); F. Role (p=0.015); F. Cognitive (p= 0.002); F. Social (p < 0.001); Pain (p=0.037) and fatigue (p=0.006).
The global acceptance variable was highly correlated with HADS (r=-0.72) and QLQC-30 (r=0.5) and showed correlations greater than 0.4 in all dimensions of the QLQC-30 and HADS.

Conclusion: The intervention has detected high levels of anxiety, depression and quality of life problems in sarcoma patients. Acceptance scale showed a high reliability, and was predictive of anxiety, depression and quality of life impairment. Type of treatments influenced these parameters, being chemotherapy the treatment with a worse impact on the patient's psychological sphere. These preliminary data highlight the need for comprehensive care for patients with sarcoma including psychological assessment and intervention.