The utility of abbreviated patient‐reported outcomes for predicting survival in early stage colorectal cancer

Hsu, Tina; Speers, Caroline; Kennecke, Hagen F.; Cheung, Winson Y.

doi:10.1002/cncr.30511

Cited by 19 publications

(11 citation statements)

References 38 publications

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“…Within EC survivors, only very fatigued EC survivors showed a significant increased risk of all‐cause mortality. The found association in male CRC survivors is in line with the study of Hsu et al, which showed an association of fatigue with all‐cause mortality (HRadj = 1.76, 95% CI [1.34‐2.95]) in a stage II‐III CRC cohort. However, results in that study were not stratified by gender.…”

Section: Discussionmentioning

confidence: 99%

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The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

et al. 2019

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Purpose Cancer‐related fatigue (CRF) is one of the most prevalent symptoms experienced by cancer survivors. However, researchers are only beginning to elucidate the risk factors, underlying mechanism(s), and its association with other outcomes. Research on the association between CRF and mortality is limited. Methods The study sample comprised 2059 short‐term (<5 years postdiagnosis) cancer survivors from four PROFILES registry studies. Survivors diagnosed with stage I‐III colorectal cancer (CRC) or stage I‐III endometrial cancer (EC), with no evidence of disease, were identified and followed‐up by the Netherlands Cancer Registry. Fatigue was assessed with the Fatigue Assessment Scale. Cox proportional hazards models adjusted for demographic, clinical, and lifestyle characteristics were performed to assess the association of CRF with all‐cause mortality. Date of censoring was February 1, 2017. Results Prevalence of CRF varied between 35.8% (male CRC) and 43.6% (female CRC). After a median follow‐up period of 9.0 years, a total of 408 survivors (20%) had died. CRF was associated with increased all‐cause mortality in male CRC survivors (HRadj = 1.75, 95% CI [1.31‐2.33]). This association remained statistically significant after excluding survivors experiencing anhedonia. For female CRC (HRadj = 1.32, 95% CI [0.90‐1.97]) and EC (HRadj = 1.27, 95% CI [0.84‐1.90]) survivors, there was no significant association with all‐cause mortality for the fatigued group in multivariable analyses. Conclusion Our study found that CRF is significantly associated with all‐cause mortality in male CRC survivors, irrespective of potential confounders. This result suggests that clinicians should increase their attention towards the recognition and treatment of CRF.

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Section: Discussionmentioning

confidence: 99%

“…But for colorectal cancer (CRC), studies reveal contradictory results. Two studies could not find an association between CRF with survival, whereas one showed an association . For endometrial cancer (EC), a univariate association between CRF and survival disappeared after adjustment for confounders .…”

Section: Introductionmentioning

confidence: 99%

The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

et al. 2019

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“…However, they reported that increased fatigue was associated with worse OS (HR 1.99; P=0.00007) and DFS (HR 1.63; P=0.03). 29 Poorer survival was also associated with increased age. No other study has evaluated the relationship between objectively measured cognitive function in patients with localised cancer with survival.…”

Section: Discussionmentioning

confidence: 99%

Prognostic indices of inflammatory markers, cognitive function and fatigue for survival in patients with localised colorectal cancer

Vardy¹,

Dhillon²,

Pond

et al. 2018

ESMO Open

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BackgroundInflammation promotes the development of malignancy, while a variety of systemic markers of inflammation predict for worse cancer outcomes including recurrence and survival. Here, we evaluate the prognostic impact of cytokine concentrations, full blood count (FBC) differential ratios, cognitive function and fatigue on survival in patients with localised colorectal cancer (CRC).Patients and methodsData are from a prospective longitudinal study comparing cognitive function and fatigue in patients with CRC who did (n=173) and did not (n=116) receive adjuvant/neoadjuvant chemotherapy. Baseline blood results (prior to any chemotherapy) included cytokines and FBC from which neutrophil lymphocyte ratio, lymphocyte monocyte ratio, platelet lymphocyte ratio and platelet monocyte ratio were derived. Fatigue was measured with the Functional Assessment of Cancer Therapy-Fatigue subscale and cognitive function by a neuropsychological test battery. Kaplan-Meier methods were used to estimate disease-free survival (DFS) and overall survival (OS). Univariable and multivariable Cox regression analyses were performed to evaluate factors potentially prognostic of outcomes.ResultsAt a median follow-up of 91.2 months, 227 subjects (79%) are still alive, and 212 (73%) have no evidence of a recurrence. Five-year OS and DFS are 86% (95% CI 81% to 90%) and 77% (95% CI 71% to 82%), respectively. None of the cytokines (interleukin (IL-6), IL-1 and tumour necrosis factor) or differential ratios of blood components, fatigue or cognitive function was statistically related to DFS or OS. Patient educational status (P=0.018), stage of disease (P=0.032), alanine transaminase (P=0.003), lactate dehydrogenase (P=0.008) and carcinoembryonic antigen (P=0.002) were significant as prognostic covariates of OS in univariable analyses, with similar results for DFS.ConclusionNone of the a priori selected markers of inflammation, fatigue or cognitive function was associated with OS or DFS in this cohort of patients.Trial registration number NCT00188331, Post-results.

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“…In addition to its usefulness as a patient-reported outcome, HRQL assessments provide can serve as predictors of future outcomes, such as prognosis and survival (Coates et al, 2000; Gotay et al, 2008; Hsu, Speers, Kennecke, & Cheung, 2017; Kaplan et al, 2007; Khouli et al, 2011; Terrin et al, 2015). However, evidence linking HRQL to future healthcare utilization, particularly in pediatric populations, has been limited (Kephart & Asada, 2009; Lima & Kopec, 2005; Parkerson et al, 2001; Ryan et al, 2013; Seid et al, 2004; Wherry, et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Predicting Health Care Utilization for Children With Respiratory Insufficiency Using Parent-Proxy Ratings of Children's Health-Related Quality of Life

Rodday¹,

Graham²,

Weidner³

et al. 2017

Journal of Pediatric Health Care

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Introduction Children with chronic respiratory insufficiency and mechanical ventilation often experience acute illnesses requiring unscheduled hospitalizations. Health-related quality of life (HRQL) may predict future healthcare utilization. Methods Participants were 30 days-22 years old with chronic respiratory insufficiency (n=120). Parent-proxies completed global HRQL and general health measures. Outcomes were total healthcare (emergency department, outpatient, inpatient) and inpatient days over six months. Adjusted negative binomial regression estimated the effects of global HRQL and general health on utilization. Results Three-quarters of children had any utilization; 32% had hospitalizations. Children with poor/fair global HRQL had 3.7 times more healthcare days than very good/excellent global HRQL. Children with poor/fair global HRQL had 6.3 times more inpatient days than very good/excellent global HRQL. Similar relationships existed between general health and utilization. Discussion HRQL was associated with healthcare and inpatient days. Clinical teams can use HRQL as a marker for utilization risk, enabling potentially earlier intervention, better outcomes, and lower costs.

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The utility of abbreviated patient‐reported outcomes for predicting survival in early stage colorectal cancer

Cited by 19 publications

References 38 publications

The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

The association of cancer‐related fatigue with all‐cause mortality of colorectal and endometrial cancer survivors: Results from the population‐based PROFILES registry

Prognostic indices of inflammatory markers, cognitive function and fatigue for survival in patients with localised colorectal cancer

Predicting Health Care Utilization for Children With Respiratory Insufficiency Using Parent-Proxy Ratings of Children's Health-Related Quality of Life

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