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The longitudinal relationship between quality of life and survival in advanced stage cancer
Author(s) -
Kypriotakis George,
Vidrine Damon J.,
Francis Linda E.,
Rose Julia H.
Publication year - 2016
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.3846
Subject(s) - medicine , quality of life (healthcare) , hazard ratio , longitudinal study , cancer , oncology , survival analysis , stage (stratigraphy) , overall survival , cancer survival , proportional hazards model , pathology , confidence interval , paleontology , nursing , biology
Objectives Quality of Life (QoL) at baseline is frequently found to be a prognostic factor in cancer studies. However, little is known about the relationship of the trajectory of QoL and survival in patients with advanced cancer. This study evaluates the effects of both level and change of QoL on survival to explore the potential of utilizing longitudinal information of QoL for prognosis. Methods A series of joint models were used in a sample ( N = 512) of patients diagnosed with advanced cancer (sample consisted of nine different cancer sites) with assessments of QoL across six time points and with survival information recorded up to 28 months after diagnosis. We used FACT‐G as the QoL measure, and we evaluated the effects of change in QoL controlling for the time‐dependent effects of chemotherapy and radiation. Results The median survival for patients was 14.2 months, and 10% of the sample had survived beyond 28 months after the diagnosis of advanced cancer. The effect of change of QoL on survival was significant (hazard ratio = 0.98; p < 0.001) controlling for time‐dependent treatment effects. Also, the slope of the trajectory in QoL was found to be a significant predictor of survival (hazard ratio = 0.18; p < 0.001). Conclusion These preliminary findings suggest that the patient's longitudinal experience in QoL may be a significant prognostic factor of survival, a novel finding with potentially important implications in medical decision making. Longitudinal information on QoL can be used for updating the patient's prognosis of survival. Copyright © 2015 John Wiley & Sons, Ltd.