Breast Cancer Quality of Life and Health-state Utility at a Brazilian Reference Public Cancer Center

Guerra, Renata Leborato; Bertoni, Neilane; Corrêa, Flávia de Miranda; Fernandes, Myrian Machado; Fernandes, Ricardo; Cancela, Marianna de Camargo; Araújo, Rodrigo Moura De; Crocamo, Susanne; Santos, Marisa; Almeida, Liz Maria de

doi:10.1080/14737167.2019.1621752

Cited by 10 publications

(12 citation statements)

References 26 publications

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“…This is likely due to the fact that earlier-stage (e.g., stages I-II) cancers tend to be associated with decreased symptom impact and can often be treated with curative intent, whereas later-stage or metastatic (e.g., stage IV) cancers are often associated with increased symptomatology due to tumor growth and/or spread to other organs and can require ongoing palliative treatment with chemotherapy [62]. In addition, the HSUVs reported in the study by Guerra et al [35] were slightly lower in patients undergoing chemotherapy compared to any other cancer treatment, and even lower in patients undergoing sequential chemotherapy, irrespective of stage. This finding may be explained by an overload of distressing symptoms secondary to sequential cancer treatments or disease progression in those with advanced disease.…”

Section: Discussionmentioning

confidence: 99%

“…A total of nine studies reported HSUVs in breast cancer: six that reported on patients with the condition [29,30,[32][33][34][35], two on individuals from the general population (n = 2) [36,37], and one on healthcare experts [38]. HSUVs were based on direct methods in three studies [36][37][38], indirect methods in five studies [29,30,32,33,35], or both in one study [34]. Mean HSUVs ranged across all studies from 0.56 to 0.90 in stage I, 0.48-0.79 in stage II, 0.45-0.77 in stage III, and 0.35-0.86 in stage IV.…”

Section: Breast Cancermentioning

confidence: 99%

“…A total of nine studies reported HSUVs in breast cancer: six that reported on patients with the condition [ 29 , 30 , 32 – 35 ], two on individuals from the general population ( n = 2) [ 36 , 37 ], and one on healthcare experts [ 38 ]. HSUVs were based on direct methods in three studies [ 36 – 38 ], indirect methods in five studies [ 29 , 30 , 32 , 33 , 35 ], or both in one study [ 34 ].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The first two studies used indirect methods (EQ-5D-3L) to elicit HSUVs. In the first study, Guerra et al [ 35 ] assessed patients with newly diagnosed breast cancer who had not initiated routine treatment. The calculated disutility at stage III/IV vs stage 0–II was –0.040 based on HSUVs of 0.689 and 0.729, respectively.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…f Kim[36]: SG, hypothetical health states, general population. g Guerra[35]: EQ-5D-3L, own health state, patients.HSUVs of 0.731, 0.600, and 0.352 for stages I-II, III, and IV, respectively, generating higher disutility values for stage I-II vs IV (-0.38) than stage III vs IV (− 0.25). In a separate study by Schleinitz et al[37], women aged ≥ 25 years in a convenience sample from US primary care clinics and the community were assessed via SG, revealing that the highest disutility was produced for stage IV vs I (− 0.265), compared with stage IV vs II (− 0.195) or stage IV vs III (− 0.142).…”

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confidence: 99%

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Health state utility values by cancer stage: a systematic literature review

Pourrahmat¹,

Kim

Kansal

et al. 2021

Eur J Health Econ

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Objectives Cancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage. Methods A systematic review was conducted using Embase, MEDLINE®, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages. Results From 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., − 0.74, − 0.44, and − 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I–III) cancers. Conclusions This study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals’ quality of life and suggest value in early detection and intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

mentioning

confidence: 99%

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Health state utility values by cancer stage: a systematic literature review

Pourrahmat¹,

Kim

Kansal

et al. 2021

Eur J Health Econ

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Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry

et al. 2020

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Purpose We aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL. Methods ABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods. Results A total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = − 0.106, p = 0.3136). Conclusion Within this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.

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