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Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis

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Abstract

Purpose

To investigate the mediators of health-related quality of life (HR-QoL) in colorectal cancer (CRC) patients and effect on overall survival.

Methods

We analyzed baseline (within 1 year of diagnosis) SF-12v1 questionnaire data from 3734 CRC patients and assessed the differences in mental composite scores (MCS) and physical composite scores (PCS) by socio-demographics and risks of poor HR-QoL by these factors. Hazard ratios were generated using univariate Cox regression for MCS and PCS dichotomized using the normalized scoring-based mean of 50 and survival estimates generated using the Kaplan–Meier method.

Results

Differences in MCS and PCS were identified by sex, age, education level, alcohol use, tobacco use, and stage. Race, marital status, and cancer site differed only by PCS. Being female, never married, former alcohol user, or with stage IV disease significantly increased risk of a poor HR-QoL, with magnitudes of risk from 1.25- to 1.97-fold. Higher education level had a protective effect (MCS: P trend = 2.32 × 10−7; PCS: P trend = 5.62 × 10−14). Hispanics and African-Americans had a 1.35- and 1.57-fold risk of poor PCS, and increase in age had a protective effect for risk of poor MCS (P trend = 1.84 × 10−7). Poor MCS or PCS were associated with poor prognosis and decreased survival at 5 years (HRMCS 1.57, 95 % CI 1.41–1.76 and HRPCS 2.38, 95 % CI 2.08–2.72), and both remained significant when adjusting for age, gender, race, education level, tumor stage, and tumor site.

Conclusions

Our findings identify potential mediators for HR-QoL and suggest that baseline HR-QoL assessment may be prognostic for CRC.

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Funding

Funding support for this study was provided in part by the NIH through MD Anderson’s Cancer Center Support Grant CA016672.

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Authors and Affiliations

  1. Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Monica E. Reyes, Yuanqing Ye, Yeling Zhou, Alexander Liang, Xifeng Wu & Michelle A. T. Hildebrandt

  2. Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Scott Kopetz

  3. Department of Lymphoma/Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    M. Alma Rodriquez

  4. Office of Cancer Survivorship, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    M. Alma Rodriquez

Authors
  1. Monica E. Reyes
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Correspondence to Michelle A. T. Hildebrandt.

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Reyes, M.E., Ye, Y., Zhou, Y. et al. Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis. Qual Life Res 26, 319–330 (2017). https://doi.org/10.1007/s11136-016-1381-8

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