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Supportive Care in Cancer
Published in: Supportive Care in Cancer 5/2011

01-05-2011 | Original Article

Determinants of quality of life in patients with advanced cancer

Authors: Camilla Zimmermann, Debika Burman, Nadia Swami, Monika K. Krzyzanowska, Natasha Leighl, Malcolm Moore, Gary Rodin, Ian Tannock

Published in: Supportive Care in Cancer | Issue 5/2011

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Abstract

Purpose

Improving health-related quality of life (HRQL) is the main goal of palliative care and an important outcome for oncology trials. This study examines medical and sociodemographic determinants of HRQL in outpatients with advanced cancer.

Methods

Patients with metastatic gastrointestinal, genitourinary, breast, lung or gynecological cancer, ECOG 0-2, and clinical prognosis of 6 months to 2 years were recruited from outpatient medical oncology clinics. HRQL was measured using the FACT-G questionnaire and the FACIT-Sp meaning and peace (existential) subscale. The influence of demographic and medical characteristics on HRQL was determined using t tests and analysis of variance, with Tukey’s correction for multiple comparisons. Multivariate linear regression was used to determine independent predictors.

Results

Of 285 patients, 57% were female and the median age was 61 years; 44% were alive at latest follow-up; and of those deceased, the mean survival time was 10 months. The strongest determinants of overall HRQL were increased age (p < 0.001), good performance status (PS; p < 0.001) and survival time >6 months (p = 0.001). Compared to patients receiving cancer treatment, those awaiting new treatment had worse emotional well-being (p < 0.001), while those on surveillance or whose treatment had been stopped had worse existential well-being (p = 0.03). Male gender predicted better emotional and physical well-being and lower income predicted worse social well-being.

Conclusions

Age, PS, survival time, and treatment status are important determinants of HRQL in patients with advanced cancer. Decision aids, open communication, and involvement of supportive care specialists may improve emotional and existential distress associated with changing or stopping cancer treatment.
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Metadata
Title
Determinants of quality of life in patients with advanced cancer
Authors
Camilla Zimmermann
Debika Burman
Nadia Swami
Monika K. Krzyzanowska
Natasha Leighl
Malcolm Moore
Gary Rodin
Ian Tannock
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 5/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-0866-1

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