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Determinants of global quality of life before and after major cancer surgery: an exploratory study

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Abstract

Objective

To explore whether determinants of global quality of life (QOL) change before and after major cancer surgery.

Methods

Consecutive patients (n = 145) undergoing surgery for upper gastrointestinal cancer were prospectively studied and asked to complete the EORTC QLQ-C30 before and after 6 months. Excluded were patients found to be inoperable (n = 12) and those with missing second questionnaires (because of death n = 20, poor health (n = 10), administrative failure (n = 7) or patient refusal (n = 4)). Multivariable linear regression models investigated associations between global QOL and other scales and items of QOL adjusting for clinical variables.

Results

Some 87 patients completed both questionnaires. Before surgery the main predictors of global QOL were physical and emotional function, with adjusted increases in global QOL of 0.55 (95% CI 0.26–0.84; P < 0.001) and 0.30 (95% CI 0.14–0.45; P < 0.001) per unit increase of physical and emotional function, respectively. Six months after surgery, however, fatigue and dyspnea most strongly predicted global QOL, with adjusted differences in global QOL of −0.24 (95% CI −0.44 to −0.04; P = 0.02) per unit increase of fatigue and −6.28 (95% CI −12.64 to 0.07; P = 0.05) for those experiencing any symptoms of dyspnea.

Conclusion

Further work is needed to test these findings, but the results suggest that the global QOL scale in the QLQ-C30 is difficult to interpret and it should be considered within the context of other clinical and patient reported outcomes.

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Abbreviations

PRO:

Patient-reported outcome

QOL:

Quality of life

CI:

Confidence interval

EORTC:

European Organization for Research and Treatment of Cancer

IQR:

Interquartile range

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Acknowledgments

Financial support

Funding was provided by Karolinska Institutet faculty funds for doctoral student (MR), the Swedish Cancer Society (PL), and the UK Medical Research Council (Clinician Scientist Award JMB).

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Authors and Affiliations

  1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Unit of Esophageal and Gastric Research (ESOGAR), Stockholm, Sweden

    Martin Rutegård & Pernilla Lagergren

  2. Department of Social Medicine, Canynge Hall, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK

    Rachael Hughes, Pernilla Lagergren & Jane M. Blazeby

  3. University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    Jane M. Blazeby

Authors
  1. Martin Rutegård
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  2. Rachael Hughes
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  3. Pernilla Lagergren
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  4. Jane M. Blazeby
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Corresponding author

Correspondence to Jane M. Blazeby.

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Rutegård, M., Hughes, R., Lagergren, P. et al. Determinants of global quality of life before and after major cancer surgery: an exploratory study. Qual Life Res 18, 1131–1136 (2009). https://doi.org/10.1007/s11136-009-9534-7

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  • DOI: https://doi.org/10.1007/s11136-009-9534-7

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