Health-related quality of life in different states of breast cancer – comparing different instruments

Rautalin, Mervi; Färkkilä, Niilo; Sintonen, Harri; Saarto, Tiina; Taari, Kimmo; Jahkola, Tiina; Roine, Risto P.

doi:10.1080/0284186x.2017.1400683

Cited by 53 publications

(53 citation statements)

References 22 publications

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“…The observation that QoL can also be of assistance in guiding these decisions is interesting and should be further investigated in prospective studies. Previous real-world studies among breast cancer patients using the EQ-5D report similar to slightly higher utility scores (median ranging from 0.64-0.82) [19,20,22,24,26,42,43] compared to our median (0.69). These differences in utility scores can partly be explained by the fact that most of these studies [22,24,26,43] only included patients that were actively treated for their disease, leaving out the more vulnerable patients receiving supportive care.…”

Section: Discussionsupporting

confidence: 73%

“…These differences in utility scores can partly be explained by the fact that most of these studies [22,24,26,43] only included patients that were actively treated for their disease, leaving out the more vulnerable patients receiving supportive care. Additionally, the majority of these real-world studies [19,20,24,42] also included patients with early breast cancer for which it can be expected that the QoL will be better due to less disease-related symptom burden. Furthermore, the mean age of patients within these trials varied, where studies with a lower mean age generally reported better utility scores; e.g., the study by Kim et al reported a mean utility of 0.82 in a population with a median age of 49.3 years [43].…”

Section: Discussionmentioning

confidence: 99%

“…The primary study endpoint was to describe the health-utility score for the whole cohort. Previous studies on real-world QoL within breast cancer patients found several patient-, disease-, and treatment factors to exert a significant influence on the experienced QoL, including age [19,20], comorbidities [20], type of therapy [19][20][21][22][23][24], number of lines of therapy [21,24], location of metastases, [21,22,25], and disease progression [23,[26][27][28]. Therefor, our secondary endpoints included differences in QoL between subgroups of patients based on age (≥ 65 versus < 65 years), comorbidity according to the Charlson index (yes versus no and multiple subdivisions in comorbidity), tumor subtype (hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status), current treatment type (endocrine, chemo-and/or targeted therapy), total number of prior palliative treatment lines, and number and metastatic site(s).…”

Section: Study Endpoints and Statistical Analysesmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Study Endpoints and Statistical Analysesmentioning

confidence: 99%

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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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“…24 Rautalin et al found that the mean 15D HRQoL score after treatment of breast cancer is 0.91. 25 The present study found relatively similar results of mean 15D score of 0.88 among patients who underwent chest wall resection and reconstruction due to malignancy.…”

Section: Discussionsupporting

confidence: 78%

Health-related quality of life after oncological resection and reconstruction of the chest wall

Salo

Repo

Roine

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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There is limited information of the health-related quality of life (HRQoL) after surgical treatment of chest wall tumors. This cross-sectional study aimed to assess long-term HRQoL after chest wall reconstruction following oncological resection. Methods: Seventy-eight patients having undergone chest wall tumor resection and reconstruction during 1997-2015 were invited to complete the 15D and QLQ-C30 HRQoL instruments. Results: Altogether, 55 patients (17 men and 38 women), with a mean (SD) age of 68 (14) years, completed the questionnaires (response rate 71%). Patients had been operated due to soft tissue sarcoma (n = 16), advanced breast cancer (n = 15), osteo-or chondrosarcoma (n = 14), or other tumor (n = 10). Median time after primary surgery was 66 (IQR 38, 141) months. The resection was full thickness in 29/55 cases and partial thickness in 26/55 cases. Chest wall reconstruction was required for 47/55 cases (85%). Reconstruction was performed using softtissue flap in eight cases, skeletal stabilizations with mesh or mesh-cement-mesh (sandwich method) in 15 cases, and skeletal stabilizations and soft-tissue flap in 24 cases. Patients' mean 15D score (0.878, SD 0.111) was comparable to that of the age-and genderstandardized general population (0.891, SD 0.041). Limitations in breathing and usual activities were noted. The QLQ-C30 cancer-specific HRQoL was 72 points (maximum 100). Scores in the QLQ-C30 Functional scales ranged from 78 (Physical) to 91 (Social).

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“…Although the EORTC QLQ-30 was speci cally developed for cancer patients [27,28], past studies [29] have used it to compare the QOL between cancer and non-cancer patients. Given the complexities of low literacy levels and prevalence of non-written dialects, translating the EORTC QLQ-C30 to Dzongkha, the national language, was not feasible.…”

Section: Survey Instrumentmentioning

confidence: 99%

Palliative Care Needs among Patients with Advanced Illnesses in Bhutan

Laabar

Saunders

Auret

et al. 2020

Preprint

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Background Palliative care improves the quality of lives of patients and families affected by life-limiting illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country.Methods This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants.Results Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease.Conclusions The symptom burden experienced by patients affected by terminal and advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.

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Health-related quality of life in different states of breast cancer – comparing different instruments

Abstract: Different HRQoL instruments produce notably different HRQoL scores. The EQ-5D has a pronounced ceiling effect. Pain and fatigue are the most common symptoms associated with poor HRQoL in all disease states.

Cited by 53 publications

References 22 publications

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

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

Health-related quality of life after oncological resection and reconstruction of the chest wall

Palliative Care Needs among Patients with Advanced Illnesses in Bhutan

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