QUALITY-OF-LIFE AND SURVIVAL - THE ROLE OF MULTIDIMENSIONAL SYMPTOM ASSESSMENT

BACKGROUND. Recent data from clinical trials suggest that quality-of-l ife (QOL) measurements may independently predict survival. The relatio n between survival and QOL measurements was tested among 122 inpatient s and 96 outpatients with malignancies at one of four sites (colon, br east, ovary, or prostate) who participated in a cross-sectional valida tion study of the Memorial Symptom Assessment Scale (MSAS), a measure of the frequency of, severity of, and distress caused by physical symp toms. METHODS. The relation between MSAS summary scores and survival w as evaluated in a multivariate analysis that adjusted concurrently for other important covariates, such as age, site and extent of disease, inpatient status, Karnofsky performance status (KPS), and other QOL me asurements. RESULTS. In the multivariate analysis, extent of disease ( P < 0.0001), inpatient status (P = 0.014), higher MSAS physical sympto m subscale score (P = 0.004), and lower KPS score (P = 0.009) independ ently predicted decreased survival. Other QOL measurements did not con tribute significantly to the model. CONCLUSIONS, The MSAS physical sym ptom subscale score significantly predicts survival and adds to the pr ognostic information provided by KPS and extent of disease. Patients m ay be under-assessed regarding both the number and the severity of sym ptoms. Measurements of physical symptoms and related distress offer ad ditional prognostic information concerning the survival of patients wi th cancer and may account for the predictive value of QOL scores. (C) 1998 American Cancer Society.