Quality of life as a predictor of overall survival after breast cancer treatment
- 604 Downloads
To describe quality of life (QoL) in a cohort of surviving women 4 years after breast cancer treatment and to analyze its role as a predictor of mortality within 2 years.
This is a prospective cohort study of 544 women who have undergone surgical treatment, from 2001 to 2002 and who answered a questionnaire about QoL in 2006. After, we conducted a survival study to evaluate the association between QoL and mortality within 2 years with the same population. We conducted factor analysis between the variables of the scales of function and symptoms. Survival analysis was conducted by Kaplan–Meier, and differences in survival curves were assessed with the log-rank test, assuming significant statistical level of 5 %. The Cox proportional hazards regression model was used to explore the relationship between QoL variables (functional scales) and prognostic value for survival.
The mean age of the women was 59.1 years (SD 11.66). The mean of overall QoL score was 75.16 (SD 20.93). Using factor analysis, we identified three conditions that made up the construct of QoL in this group of patients: social, psycho-emotional, and physical. Social condition was the most important factor. After assessment of QoL, the mean survival was 23 months (SD 3.90). Women who reported worse future perspective had higher chance of death compared with women better prospect of future (HR = 3.46; 95 % CI 1.36–8.79; p value = 0.009).
Future perspectives were predictors of mortality, which reinforce the relevance of social support and psychological aspects for these women.
KeywordsBreast cancer Survivors Quality of life Overall survival Predicting factors Incidence
- 1.Ferlay, J., Shin, H. R., Bray, F., Forman, D., Mathers, C., Parkin, D. M. (2010). GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Accessed May 25, 2012, from http://globocan.iarc.fr.
- 2.Siegel, R., DeSantis, C., Virgo, K., Stein, K., Mariotto, A., Smith, T., et al. (2012). Cancer treatment and survivorship statistics. CA: A Cancer Journal for Clinicians, 62(4), 220–241.Google Scholar
- 4.DiSantis, C., Siegel, R., Bandi, P., & Jemal, A. (2011). Breast cancer statistics. CA: A Cancer Journal for Clinicians, 61(6), 409–418.Google Scholar
- 5.National Institute Cancer. U.S. National Institutes of Health. (2013). Accessed April 4, 2013, from www.cancer.gov.br.
- 8.Meeske, K., Smith, A. W., Alfano, C. M., McGregor, B. A., McTiernan, A., Baumgartner, K. B., et al. (2007). Fatigue in breast cancer survivors two to five years post diagnosis: A HEAL Study report. Quality of Life Research. doi: 10.1007/s11136-007-9215-3.
- 16.Efficace, F., Biganzoli, L., Piccart, M., Coens, C., Van Steen, K., Cufer, T., et al. (2004). Baseline health-related quality-of-life data as prognostic factors in a phase III multicentre study of women with metastatic breast cancer. European Journal of Cancer, 40(7), 1021–1030.PubMedCrossRefGoogle Scholar
- 17.Kramer, J. A., Curran, D., Piccart, M., Haes, J. C. J. M., Bruning, P., Klijn, J., et al. (2000). Identification and interpretation of clinical and quality of life prognostic factors for survival and response to treatment in first-line chemotherapy in advanced breast cancer. European Journal of Cancer, 36(12), 1498–1506.PubMedCrossRefGoogle Scholar
- 18.Luoma, M. L., Hakamies-Blomqvist, L., Sjöströn, J., Pluzanska, A., Ottoson, S., Mouridsen, H., et al. (2003). Prognostic value of quality of life scores for time to progression (TTP) and overall survival time (OS) in advanced breast cancer. European Journal of Cancer, 39(10), 1370–1376.PubMedCrossRefGoogle Scholar
- 19.Reynolds, P., Boyd, P. T., Blacklow, R. S., Jackson, J. S., Greenberg, R. S., Austin, D. F., et al. (1994). The relationship between social ties and survival among black and white breast cancer patients. Cancer Epidemiology, Biomarkers & Prevention, 3, 253–259.Google Scholar
- 25.Guerra, M. R., Mendonça, G. A. S., Bustamante-Teixeira, M. T., Cintra, J. R. D., Carvalho, L. M., & Magalhães, L. M. P. V. (2009). Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil. Cadernos Saúde Pública, 25(11), 2455–2466.CrossRefGoogle Scholar
- 28.Kluthcovsky, A. C. G. C., Urbanetz, A. A., Carvalho, D. S., Maluf, E. M. C. P., Sylvestre, G. C. S., & Hatschbach, S. B. B. (2012). Fatigue after treatment in breast cancer survivors: Prevalence, determinants and impact on health-related quality of life. Support Care Cancer, 20, 1901–1909.CrossRefGoogle Scholar
- 29.Bergmann, A. (2005). Incidência e fatores de risco do linfedema após tratamento cirúrgico para câncer de mama: Estudo de uma coorte hospitalar. Dissertation, National School of Public Health—Oswaldo Cruz Foundation, Rio de Janeiro (RJ), Brazil.Google Scholar
- 30.Bergmann, A., Koifman, R. J., Ribeiro, M. J. P., & Mattos, I. E. (2007). Upper limb lymphedema following breast cancer surgery: Prevalence and associated factors. Lymphology, 40(Suppl.), 96–106.Google Scholar
- 32.Moura Junior, L. G. (2007). Qualidade de vida e câncer de mama: uma comparação entre mulheres com e sem linfedema. Dissertation, National School of Public Health—Oswaldo Cruz Foundation, Rio de Janeiro (RJ), Brazil.Google Scholar
- 33.Fayers, P. M., Aaronson, N. K., Bjordal, K., Groenvold, M., Curran, D., Bottomley, A., et al. (2001). The EORTC QLQ-C30 Scoring Manual (3rd ed.). Brussels: European Organization for Research and Treatment of Cancer.Google Scholar
- 43.Groenvold, M., Petersen, M. A., Idler, E., Bjorner, J. B., Fayers, P. M., Mouridsen, H. T. (2007). Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Research and Treatment. doi: 10.1007/s10549-006-9447-x.
- 44.Svensson, H., Hatschek, T., Johansson, H., Einbeigi, Z., Brandberg, Y. (2012). Health-related quality of life as prognostic factor for response, progression-free survival, and survival in women with metastatic breast cancer. Medical Oncology. doi: 10.1007/s12032-011-9844-9.