Quality of life in lung cancer patients - As an important prognostic factor

Given that lung cancer is one of the common cancers world-wide, the implica tions of focusing on quality of life as well as survival require to be unde rstood. We have carried out a study of the relationship between survival an d quality of life in patients with lung cancer comparing patients those who lived with those who died within 3 months. The design of the study allowed every patient in a defined geographical area with a potential diagnosis of lung cancer to be studied ti-om first outpatient consultation till after a definitive treatment has been given. Quality of life was measured using th ree standard questionnaires: the Nottingham Health Profile (NHP), the Europ ean Organization for Research acid Treatment of Cancer Quality of Life Ques tionnaire (EORTC QLQ-C30) and its lung cancer supplementary questionnaire ( QLQ-LC13) in addition to a study specific questionnaire collecting data on demographic, social, clinical and performance status. The contribution of q uality of life in relation to survival adjusted for known prognostic factor s was determined using Cox's proportional hazard model. In all 129 lung can cer patients were interviewed, and 96 patients were alive at 3-months follo w-up. Only 90 of 96 patients alive at 3-months follow-up were assessable. D escriptive analyses showed that those who were dead had more perceived heal th problems, greater level of symptoms and significant lower physical and r ole functioning and global quality of life at presentation. On the other ha nd, univariate analyses showed that patients' aggregate scores on the NHP, the functioning scores, and global quality of life scores alone were signif icant predictors of survival (P < 0.03. P < 0.04. P(0.04, respectively). Th e multivariate analyses showed that pre-diagnosis global quality of life wa s the most significant predictor of the length of survival even after adjus ting for known prognostic factors (age, P(0.04; extent of disease. P<0.03: global quality of life. P < 0.02), while performance status. sex and weight loss were not. This stud?; confirmed that pre-diagnosis quality of life wa s a significant predictor of survival. Indeed, pre-diagnosis quality of lif e should be considered as a clinical status which has to be established by physicians before treatment starts as it is such an important predictor of survival. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.