Quality of life as a potential predictor for morbidity and mortality in patients with metastatic hormone-refractory prostate cancer

Sullivan, Patrick W.; Nelson, Joel B.; Mulani, Parvez; Sleep, Darryl J.

doi:10.1007/s11136-006-0003-2

Cited by 59 publications

(61 citation statements)

References 39 publications

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“…45,47 In this context, Oliva et al reported a study on elderly AML patients in which QOL physical functioning was of prognostic relevance yet, somewhat surprisingly, did not correlate to the physician-assessed ECOG performance status. 48 While the item 'fatigue' has been shown to be prognostically relevant in several different malignant diseases, 47,[49][50][51] so far only hypotheses to explain the mechanisms underlying the association between reported data on patient health status and duration of survival have been proposed. 52 'Fatigue' is a patient-reported outcome and multi-faceted concept including both mental and physical components whose critical domains have not been sufficiently standardized and for which several scales have been developed.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

et al. 2012

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Myelodysplastic syndromes and acute myeloid leukemia exemplify the complexity of treatment allocation in older patients as options range from best supportive care, non-intensive treatment (e.g. hypomethylating agents) to intensive chemotherapy/hematopoietic cell transplantation. Novel metrics for non-disease variables are urgently needed to help define the best treatment for each older patient. We investigated the feasibility and prognostic value of geriatric/quality of life assessments aside from established disease-specific variables in 195 patients aged 60 years or over with myelodysplastic syndromes/acute myeloid leukemia. These patients were grouped according to treatment intensity and assessed. Assessment consisted of eight instruments evaluating activities of daily living, depression, mental functioning, mobility, comorbidities, Karnofsky Index and quality of life. Patients with a median age of 71 years (range 60-87 years) with myelodysplastic syndromes (n=63) or acute myeloid leukemia (n=132) were treated either with best supportive care (n=47), hypomethylating agents (n=73) or intensive chemotherapy/hematopoietic cell transplantation (n=75). After selection of variables, pathological activities of daily living and quality of life/fatigue remained highly predictive for overall survival in the entire patient group beyond disease-related risk factors adverse cytogenetics and blast count of 20% or over. In 107 patients treated non-intensively activities of daily living of less than 100 (hazard ratio, HR 2.94), Karnofsky Index below 80 (HR 2.34) and quality of life/'fatigue' of 50 or over (HR 1.77) were significant prognosticators. Summation of adverse features revealed a high risk of death (HR 9.36). In-depth evaluation of older patients prior to individual treatment allocation is feasible and provides additional information to standard assessment. Patients aged 60 years or over with newly diagnosed myelodysplastic syndromes/acute myeloid leukemia and impairments in activities of daily living, Karnofsky Index below 80%, quality of life/'fatigue' of 50 or over, are likely to have poor outcomes.Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

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Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

et al. 2012

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“…Baseline global QOL was a strong independent predictor of survival in patients with advanced CRC in one study [Maisey et al 2002], while in another study, the patient's score on the social functioning scale translated into a 9% decrease in the patient's hazard of death for any 10-point increase in the score (0 to 100 scale) [Efficace et al 2008[Efficace et al , 2006a. A correlation between various pretreatment PRO domain scores, including overall quality of life [Qi et al 2009], global quality of life [Movsas et al 2009 [Roychowdhury et al 2003] and total quality of life score in metastatic HRPC [Sullivan et al 2006] and in localized prostate cancer [Sadetsky et al 2009] have been associated with survival.…”

Section: Prediction and Prognosismentioning

confidence: 99%

Health-related quality of life and cancer clinical trials

2011

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The measurement of patient-reported outcomes, including health-related quality of life, is a new initiative which has emerged and grown over the past four decades. Following the development of reliable and valid self-report questionnaires, health-related quality of life has been assessed in tens of thousands of patients and a wide variety of cancers. This review is based on a selection of data published in the last decade and is intended primarily for healthcare professionals. The assessments in clinical trials have been particularly useful for elucidating the effects of various cancers and their treatments on patients' lives and have provided additional information that enhances the usual clinical endpoints used for determining the benefits and toxicity of treatment. With growing experience the quality of the healthrelated quality of studies has improved and, in general, recent studies are more likely to be methodologically robust than those that were performed in earlier decades. Health-related quality of life has become a more accurate predictor of survival than some other clinical parameters, such as performance status. The overall outlook for the routine assessment of patient-reported outcomes in clinical trials is assured and, eventually, it is likely to become a standard part of clinical practice. However, there is still a need for a clear method for determining the clinical meaningfulness of changes in scores. The answer will probably come from the greater use of patient-reported outcomes and the consequent growth of experience that is necessary to make such judgements.

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“…The association between baseline QoL and survival in prostate cancer has been investigated and reported in a few previously published studies [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Baseline or pretreatment QoL has been shown to be a prognostic indicator in prostate cancer in previously published studies [10][11][12][13]. However, to the best of our knowledge, there is no study in the literature investigating the prognostic impact of changes in QoL scores on survival in prostate cancer, whether this is assessed at the time of initial cancer diagnosis or following disease relapse.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of changes in quality-of-life scores in prostate cancer.

Gupta¹,

Braun²,

Staren³

2011

JCO

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Background: Several studies in the oncology literature have demonstrated the prognostic value of baseline quality of life (QoL). We investigated whether changes in QoL could predict survival in prostate cancer patients. Methods: We evaluated 250 prostate cancer patients treated at our institution between Jan 2001 and Dec 2009 who were available for a minimum follow-up of 3 months. QoL was evaluated at baseline and after 3 months of treatment initiation using EORTC-QLQ-C30. Cox regression evaluated the prognostic significance of baseline and changes in QoL scores after adjusting for relevant clinical and demographic variables. Results: Median overall survival was 89.1 months (95% CI: 56.5-121.7). Baseline QoL scale predictive of survival upon multivariate analysis was fatigue (p = 0.001). Associations between changes in QoL and survival, upon multivariate analysis, were observed for dyspnea and cognitive functioning. Every 10-point increase (worsening) in dyspnea was associated with a 16% increased risk of death (HR = 1.16; 95% CI = 1.02 to 1.30, p = 0.02), and every 10-point increase (improvement) in cognitive functioning was associated with a 24% decreased risk of death (HR = 0.76; 95% CI = 0.54 to 0.98, p = 0.04). Conclusions: This study provides preliminary evidence to indicate that prostate cancer patients with better baseline fatigue and patients whose dyspnea and cognitive functioning improves within 3 months of treatment are at a significantly decreased risk of mortality.

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Quality of life as a potential predictor for morbidity and mortality in patients with metastatic hormone-refractory prostate cancer

Cited by 59 publications

References 39 publications

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

Health-related quality of life and cancer clinical trials

Prognostic value of changes in quality-of-life scores in prostate cancer.

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