(ChemotherapyAdvisor) – In patients with lung cancer, overall quality of life (QOL) — measured by a simple, single item at diagnosis — “is a significant and independent prognostic factor for survival,” according to a study in Journal of Clinical Oncology online March 26.
“Over and above performance status and key clinical and demographic variables, a QOL patient-reported outcome assessment can identify deficits that are independently associated with abbreviated survival,” noted Sloan et al. from the Mayo Clinic, Rochester, MN.
They evaluated prognostic value of QOL assessments with regard to overall survival in 2,442 patients with non–small-cell lung cancer observed between 1997 and 2007. QOL was assessed at all follow-up time points by means of one item from the Lung Cancer Symptom Scale, which each patient had completed within the first six months of receiving a diagnosis of lung cancer. These results were dichotomized using an a priori definition of a clinically deficient score, defined as ≤50 vs. >50.
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Deficits in QOL at lung cancer diagnosis were found to be significantly associated with overall survival (HR, 1.55; P<0.001), as were performance status, older age, smoking history, male sex, treatment factors, and disease stage. For patients with a clinically deficient QOL score, median survival was 1.6 years vs. 5.6 years for those with a non clinically deficient QOL score. After controlling for covariates, a clinically deficient baseline QOL was found to contribute significantly to the prediction of patient survival (HR, 0.67; P<0.001).
“These findings add to the ever-growing research literature that points toward an important and crucial role for assessing QOL in clinical practice and hold the potential for identifying subsets of patients who are experiencing deficits in QOL and may therefore benefit from specific attention to these expressed QOL needs,” they wrote. “The next step in this line of research is to develop and test interventions to apply when QOL deficits occur to improve patient QOL and survival.”
