Self-reported health-related quality of life predicts survival for patients with advanced gastric cancer treated with first-line chemotherapy

• DOI: 10.1007/s11136-008-9307-8
• Publication Date: 2008-01-25T15:16:07Z
• Authors: Se Hoon Park; Moon Sook Cho; Young Saing Kim; Junshik Hong; Eunmi Nam; Jinny Park; Eun Kyung Cho; Dong Bok Shin; Jae Hoon Lee; Woon Kee Lee
• Keywords: Adult; Male; Age Factors; Social Support; Bone Neoplasms; Middle Aged; Prognosis; Survival Analysis; Self Concept; 3. Good health; Cohort Studies; Hemoglobins; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Stomach Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Quality of Life; Humans; Female; Aged; Proportional Hazards Models; Randomized Controlled Trials as Topic

To determine whether patients' self-reported quality-of-life (QOL) parameters could predict survival for patients with advanced gastric cancer (AGC) treated with first-line chemotherapy, we performed this analysis based on the data obtained from 254 patients enrolled in three consecutive prospective randomized trials at a single institution.Consenting patients with AGC received first-line chemotherapy as specified in the protocols. QOL was assessed at baseline using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaires. Baseline univariate and multivariate analyses were performed on the QOL data and the recognized clinical predictors for survival.Of 254 patients, 164 completed the QOL questionnaire at baseline. All patients received fluorouracil-containing first-line chemotherapy for AGC. With 88% observed deaths and a reported median survival of 9.5 months [95% confidence interval (CI) 8.8-10.2 months], there were no significant differences in survival between patients with or without QOL data. The final Cox multivariate model revealed four prognostic factors: age [hazard ratio (HR) 2.08, 95% CI 1.32-3.33, P = 0.002], bone metastasis (HR 2.70, 95% CI 1.30-5.56, P = 0.008), hemoglobin (HR 0.58, 95% CI 0.37-0.92, P = 0.020), and social functioning (HR 0.40, 95% CI 0.23-0.64, P = 0.001). When adjusting for clinical parameters, social functioning was an independently significant prognostic factor for longer survival.Baseline social functioning, along with age, presence of bone metastasis, and baseline hemoglobin level, independently predicts survival of AGC patients treated with first-line chemotherapy. QOL assessment should be routinely included to provide useful prognostic information concerning AGC patients.