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EORTC QLQ-C15-PAL quality of life score as a prognostic indicator of survival in patients with far advanced cancer

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Abstract

Purpose

Quality of life (QoL) and performance status predict survival in advanced cancer patients; these relationships have not been explored in the hospice palliative care setting. The aim of this study was to examine the survival predictability of patient-reported QoL using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL questionnaire in far advanced cancer inpatients at the very end of life.

Methods

This is a retrospective cohort study. Patients reported QoL using the EORTC QLQ-C15-PAL. One hundred sixty-two inpatients in hospice palliative wards of six hospitals in South Korea were followed until death or the end of the study. Additional symptoms and performance status were assessed by the MD Anderson Symptom Inventory—Korean (MDASI-K), Palliative Performance Scale (PPS) and Eastern Cooperative Oncology Group (ECOG) performance status. Correlations between EORTC QLQ-C15-PAL, MDASI-K, PPS, and ECOG were assessed. Survival analyses were performed using Cox proportional hazard models.

Results

Patients’ median survival was less than 1 month. Physician-reported PPS significantly predicted survival (hazard ratio [HR] 0.493; p < 0.001). From the EORTC QLQ-C15-PAL, patient-reported physical functioning predicted survival (HR = 0.65; p < 0.001). Other six domains of EORTC QLQ-C15-PAL were significantly related to survival after adjustment. Those domains were global health status, emotional functioning, fatigue, nausea/vomiting, appetite loss, and constipation.

Conclusions

EORTC QLQ-C15-PAL can be an independent prognostic factor in inpatients with far advanced cancer. Patient-reported physical functioning showed survival predictability as good as physician-reported performance status. It is notable that the QLQ instrument is useful even for patients in their final month of life. Cancer anorexia–cachexia syndrome-related symptoms may be independent prognostic symptoms. Prospective study is warranted.

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Conflict of interest

We do not have any financial relationships to disclose. We have full control over all primary data and agree to allow Supportive Care in Cancer to review the data.

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Authors and Affiliations

  1. College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Yong Joo Lee

  2. Department of Medicine, Dongguk University-Seoul, Pil-dong 3-ga, Jung-gu, Seoul, South Korea

    Sang-Yeon Suh

  3. Department of Family Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea

    Sang-Yeon Suh & Eunji Yim

  4. Department of Family Medicine, Korea University Guro Hospital, Seoul, South Korea

    Youn Seon Choi

  5. Department of Family Medicine, Gangnam Severance Hospital, Yonsei University Health System, Seoul, South Korea

    Jae Yong Shim

  6. Department of Statistics, Dongguk University-Seoul, Seoul, South Korea

    Ah-Ram Seo, Sung-Eun Choi & Hong-Yup Ahn

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  1. Yong Joo Lee
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  2. Sang-Yeon Suh
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Correspondence to Sang-Yeon Suh.

Additional information

This paper was presented in part by poster at the 7th World Research Congress of the European Association for Palliative Care, Trondheim, Norway, June 7–9, 2012.

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Lee, Y.J., Suh, SY., Choi, Y.S. et al. EORTC QLQ-C15-PAL quality of life score as a prognostic indicator of survival in patients with far advanced cancer. Support Care Cancer 22, 1941–1948 (2014). https://doi.org/10.1007/s00520-014-2173-8

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  • DOI: https://doi.org/10.1007/s00520-014-2173-8

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