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Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease

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Abstract

Purpose

To explore end-stage breast, prostate, and colorectal cancer patients’ health-related quality of life (HRQoL); to compare results obtained by different HRQoL instruments; and to explore factors related to impaired HRQoL.

Methods

A cross-sectional observational study utilized two generic HRQoL instruments, the 15D and the EQ-5D, and a cancer-specific instrument, the EORTC QLQ-C30. Patients were recruited from the Helsinki University Hospital’s Department of Oncology and from a local hospice.

Results

Of the 114 palliative care patients included in the analysis, 27 had breast cancer, 30 had prostate cancer, and 57 had colorectal cancer. Of these, 28 % died within 3 months after their response, while 32 % died within three to 6 months, and 39 % died more than 6 months after. Utility values varied widely by instrument: the 15D gave the highest utility values and VAS the lowest (15D: 0.74, EQ-5D: 0.59 and VAS: 55). Patients close to death had lower HRQoL scores independently from the instrument used. The EQ-5D showed a pronounced ceiling effect, with 13 % of patients reporting full health, whereas the corresponding figures for the 15D and VAS were 1 and 0 %, respectively. Fatigue was the most common symptom and also predicted impaired HRQoL most significantly.

Conclusions

All instruments were applicable for the evaluation of HRQoL among end-stage cancer patients. Fatigue seemed to be the most significant deteriorating factor, whereas clinical and demographic factors had less of an effect on HRQoL.

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Acknowledgments

All authors participated in the study design, data collection, and drafting of the manuscript. NF and ST had joint responsibility for writing the manuscript and share primary authorship. This work was supported by the Cancer Society of Finland and GlaxoSmithKline Finland.

Conflict of interest

NF is GlaxoSmithKline Finland employee. ST is Teva Pharmaceuticals Europe employee. HS is the developer of the 15D instrument and has received fees for consultancy from MSD, Eli Lilly, Pfizer, Novartis, Merck, and Finohta. KT has received fees for consultancy from Astellas, GlaxoSmithKline, and Ferring. TS has received payments for lectures on palliative medicine from different associations.

Author information

Authors and Affiliations

  1. Department of Public Health, Hjelt-Institute, University of Helsinki, Helsinki, Finland

    Niilo Färkkilä, Saku Torvinen & Harri Sintonen

  2. GlaxoSmithKline, Espoo, Finland

    Niilo Färkkilä

  3. Hospital District of Helsinki and Uusimaa, Helsinki, Finland

    Risto P. Roine

  4. Terhokoti Hospice, Helsinki, Finland

    Juha Hänninen

  5. Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland

    Kimmo Taari

  6. Department of Urology, Helsinki University Central Hospital, Helsinki, Finland

    Kimmo Taari

  7. Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland

    Tiina Saarto

Authors
  1. Niilo Färkkilä
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  2. Saku Torvinen
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  3. Risto P. Roine
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  4. Harri Sintonen
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  5. Juha Hänninen
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  6. Kimmo Taari
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  7. Tiina Saarto
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Corresponding author

Correspondence to Niilo Färkkilä.

Additional information

Trial registration: This trial has been registered in the Helsinki and Uusimaa Hospital District Register (www.hus.fi) with the unique trial number 233895.

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Färkkilä, N., Torvinen, S., Roine, R.P. et al. Health-related quality of life among breast, prostate, and colorectal cancer patients with end-stage disease. Qual Life Res 23, 1387–1394 (2014). https://doi.org/10.1007/s11136-013-0562-y

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  • DOI: https://doi.org/10.1007/s11136-013-0562-y

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