{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T11:23:58Z","timestamp":1794309838744,"version":"4.9.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Soft tissue and bone sarcomas may carry a considerable symptom burden, which typically worsens in the final weeks of life. To help clarify personalized palliative care needs, we investigated discrepancies in end-of-life management between patients with sarcoma and those with the most common carcinomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study enrolled all sarcoma patients who died between 1 January 2018 - 31 October 2023, either in the palliative care unit or in medical oncology units, at a large cancer hospital in northern Italy. Each patient with sarcoma was matched with up to three randomly selected patients with carcinoma. Matching was based on age, year of death and unit. Electronic health records were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty-six patients with sarcoma were matched with 96 patients with carcinoma (44 lung cancer, 40 breast cancer and 12 colorectal cancer). Patients with sarcoma had a significantly higher chance of palliative sedation compared with patients with carcinoma (OR=32.5). The most common refractory symptom in patients with sarcoma was dyspnea (50%), followed by pain (26%). The average opioid dose difference between patient groups during sedation was as high as 220 mg. The final recorded Richmond Agitation-Sedation Scale score (RASS) was on average -4.4 for patients with sarcoma who died in hospice compared to -2.5 for those who died in an oncology unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In our series, patients with sarcoma had a substantially higher risk of experiencing refractory symptoms requiring palliative sedation compared to patients with the most common cancers. Pain and dyspnea were the most common refractory symptoms in patients with sarcoma, resulting in higher dosages of opioids and possibly impacting sedation deepness. This study suggests that patients with sarcoma may pose special challenges to end-of-life care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03008916261446214","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:20:03Z","timestamp":1781590803000},"page":"405-412","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["End-of-life care: A retrospective study comparing sarcoma and patients with carcinoma"],"prefix":"10.1177","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1764-016X","authenticated-orcid":false,"given":"Luca","family":"Zambelli","sequence":"first","affiliation":[{"name":"Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Massa","sequence":"additional","affiliation":[{"name":"Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health \u2013 Dipartimento di Eccellenza 2023 - 2027, Universit\u00e0 degli Studi di Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5868-3954","authenticated-orcid":false,"given":"Francesca","family":"Ricchini","sequence":"additional","affiliation":[{"name":"Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Zecca","sequence":"additional","affiliation":[{"name":"Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0425-4692","authenticated-orcid":false,"given":"Salvatore","family":"Provenzano","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Tin\u00e8","sequence":"additional","affiliation":[{"name":"Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalba","family":"Miceli","sequence":"additional","affiliation":[{"name":"Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0375-6204","authenticated-orcid":false,"given":"Augusto","family":"Caraceni","sequence":"additional","affiliation":[{"name":"Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health \u2013 Dipartimento di Eccellenza 2023 - 2027, Universit\u00e0 degli Studi di Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Giovanni","family":"Casali","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori"},{"name":"Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/2045-3329-2-14"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.07.006"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/740279"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.10.357"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163231220225"},{"key":"e_1_3_2_7_2","unstructured":"SICP \u2013 SIAART. 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