Prognostic value of quality of life score in disease-free survivors of surgically-treated lung cancer

Abstract

BackgroundWe aimed to evaluate the prognostic value of quality of life (QOL) for predicting survival among disease-free survivors of surgically-treated lung cancer after the completion of cancer treatment.MethodsWe administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Quality of Life Questionnaire Lung Cancer Module (QLQ-LC13), Hospital Anxiety and Depression Scale (HADS), and Posttraumatic Growth Inventory (PTGI) to 809 survivors who were surgically-treated for lung cancer at two hospitals from 2001 through 2006. We gathered mortality data by linkage to the National Statistical Office through December 2011. We used Cox proportional hazard models to compute adjusted hazard ratios (aHRs) and 95 % confidence intervals (CIs) to estimate the relationship between QOL and survival.ResultsAnalyses of QOL items adjusted for age, sex, stage, body mass index, and physical activity showed that scores for poor physical functioning, dyspnea, anorexia, diarrhea, cough, personal strength, anxiety, and depression were associated with poor survival. With adjustment for the independent indicators of survival, final multiple proportional hazard regression analyses of QOL show that physical functioning (aHR, 2.39; 95 % CI, 1.13–5.07), dyspnea (aHR, 1.56; 95 % CI, 1.01–2.40), personal strength (aHR, 2.36; 95 % CI, 1.31–4.27), and anxiety (aHR, 2.13; 95 % CI, 1.38–3.30) retained their independent prognostic power of survival.ConclusionThis study suggests that patient-reported QOL outcomes in disease-free survivors of surgically-treated lung cancer after the completion of active treatment has independent prognostic value for long-term survival.

Concerns and Quality of Life of Cancer Survivors Across the Survivorship Trajectory

“…In the context of cancer survivors, side effects of cancer and its treatment [11,12,18], financial concerns [16,19], distress over recurrence [19], family-related distress [19] have been found to affect survivors' QOL. It is an important predictor in outcomes of the disease and its treatment [20] and one of the indicators of adjustment in cancer survivors [12]. It is therefore crucial to understand and address not only the immediate but also the long-term medical and psychosocial issues that confront cancer survivors as they transit across the survivorship trajectory in order to enhance coping skills and improve their QOL.…”

Patient-Reported Outcomes in Cardiothoracic Surgery

“…PRO measures can give us a more accurate picture of patients' clinical status, allowing for early intervention. For example, studies have shown that changes in QoL scores are independent predictors of survival in patients with lung cancer [10]. In addition to better informing clinicians on the postoperative course of their patients, PRO measures can provide cardiothoracic surgeons with quality information to help patients make treatment-related decisions.…”

“…A variety of both retrospective and prospective studies have similarly examined PRO and HRQoL results after operation for thoracic malignancies [2,10,[30][31][32][33][34][35][36][37]. A summary of select studies that examined PROs after lung cancer operation is shown in Table 2.…”

“…Results from that analysis found a significantly greater decrease in physical function scores after pneumonectomy [42]. Finally, in one of the largest studies, Yun and colleagues [10] conducted surveys of more than 800 patients undergoing lung cancer operations. They investigated the relationship between PROs and long-term survival and found postoperative physical function, dyspnea, personal strength, and anxiety to be independent predictors of long-term survival [10].…”

Increased expression of SLC35F2 in non-small cell lung cancer predicts poor prognosis

“…Although early detection, diagnosis and targeted therapy of NSCLC have made great progress, the five-year survival rate is still very low (3). Regional or distant metastasis is a risk factor for relapse and poor prognosis of NSCLC (3). However, there are currently no effective biomarkers to predict poor prognosis in NSCLC (4).…”