Is quality of life predictive of the survival of patients with advanced nonsmall cell lung carcinoma?

Abstract:

BACKGROUND:Several studies have recently reported on the importance of quality of life (QOL) in predicting the survival of patients with lung carcinoma. To confirm these reports, the relationship between survival and QOL, as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire and Duke-UNC Social Support Scale, was examined within a group of 206 patients with advanced nonsmall cell lung carcinoma treated in a randomized clinical trial conducted by the Cancer and Leukemia Group B (CALGB 8931). METHODS:Patients completed the EORTC instrument and the Duke-UNC Social Support Scale at baseline in the clinic. The Cox proportional hazards model was used to determine the incremental contribution QOL provided in predicting survival beyond the effect of known clinical prognostic variables. RESULTS:Clinical factors that were jointly predictive of poorer survival included low performance status, nonadenocarcinoma histology, presence of dyspnea, weight loss greater than 5%, albumin level less than 3.5 mg/dL, and adrenal metastases. Univariate analyses showed that patient-reported EORTC subscales describing increased pain, appetite loss, fatigue, lung carcinoma symptoms, poorer overall QOL, and poorer physical functioning predicted significantly poorer survival. Multivariate analyses showed that, after adjustment for clinical factors, overall QOL was not a significant predictor of survival. Rather, the only EORTC subscale of prognostic importance was the pain subscale, in which a 40-point increase was associated with a 27% increase in the hazard rate. CONCLUSIONS:This study did not confirm the prognostic importance of overall QOL. Rather, after adjustment for significant clinical factors, a patient-provided pain report had the greatest prognostic importance.

journal_name

Cancer

journal_title

Cancer

authors

Herndon JE 2nd,Fleishman S,Kornblith AB,Kosty M,Green MR,Holland J

doi

10.1002/(sici)1097-0142(19990115)85:2<333::aid-cnc

subject

Has Abstract

pub_date

1999-01-15 00:00:00

pages

333-40

issue

2

eissn

0008-543X

issn

1097-0142

pii

10.1002/(SICI)1097-0142(19990115)85:2<333::AID-CNC

journal_volume

85

pub_type

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