Quality of Life Found to Influence Survival in
Cancer Patients
Mayo researchers find ‘quality of life was a strong
predictor of survival’
May 16, 2008 - Patients that feel better live
longer, say Mayo Clinic researchers. Angelina Tan, the study’s lead
author, says the results show quality of life is an independent factor
in survival.
“Quality of life appears to affect the survival of
cancer patients,” says Tan. “If physicians can identify patients who are
not doing well, they will be able to intervene and, we hope, improve not
only their patients’ sense of well-being, but also their length of
life.”
The Mayo researchers worked with the North Central
Cancer Treatment Group (NCCTG) on the study. Results were released May
15 as part of the 44th Annual Meeting of the American Society of
Clinical Oncology (ASCO).
The researchers compared overall survival with
responses from 3,704 patients to one question -- “On a scale of 0 to 10,
how would you rate your quality of life?”
Patients had a variety of cancer types, and the
question was asked during their participation in one of 24 different
NCCTG clinical trials. The unifying factor for the patients was that all
had late-stage disease. All results were converted to a 100-point scale.
The team found that baseline quality of life was a
strong predictor of survival.
They found a distinct difference when dividing
patients by the median score of 83 (6.1 months increased survival time
for those with scores greater than or equal to 83).
The investigators also divided the group into those
with scores of more than 50 and 50 or less, defining those in the 50 or
less category as having clinically deficient quality of life.
In this analysis, the results were even more
striking, with increased survival of 7.5 months for the non-clinically
deficient patients. The investigators determined that these numbers were
independent of performance status (a traditionally used survival
prediction method evaluating a patient’s ambulatory status).
This study is one of several similar quality of
life studies that are being presented by Mayo Clinic researchers at the
ASCO annual meeting.
“Quality of life research is a priority at Mayo,”
says Jeff Sloan, Ph.D., a cancer researcher at Mayo and the study’s
primary investigator. “While doctors know that a patient’s quality of
life is important, these studies show that measuring it is necessary and
can predict how patients will do.”
Dr. Sloan, Tan and their colleagues at Mayo Clinic
and NCCTG hope current and future research will identify both how and
when clinicians can best support their patients’ feelings of well-being.
For example, if the quality of life deficit was identified to be related
to patient fatigue and emotional distress, interventions
(pharmaceutical, psychosocial, etc.) could be offered to improve patient
well-being.
“If quality of life deficits can be identified
routinely in clinical practice, it will help patients,” says Tan.
“Physicians can address the issues leading to a decrease in quality of
life, and ideally these interventions will extend survival.”
Other researchers included Paul Novotny; Judith
Kaur, M.D.; and Jan Buckner, M.D., all from Mayo Clinic. NCCTG
researchers included Paul Schaefer, M.D., Toledo Community Hospital
Oncology Program, Toledo, Ohio; Philip Stella, M.D., St. Joseph Mercy
Health System, Ann Arbor, Mich.; and John Kuebler, M.D., Columbus
Community Clinical Oncology Program, Columbus, Ohio.
Editor’s Notes:
Related quality of life studies being presented at
ASCO include:
>> Baseline quality of life is a strong prognostic
factor for overall survival in patients with advanced stage non-small
cell lung cancer, Schild et al.
>> A quality-of-life assessment of patients
participating in phase I clinical trials confirms a decrease during
treatment, Atherton et al.
>> Baseline quality of life is a strong and
performance status-independent prognostic factor for overall survival in
patients with metastatic colorectal cancer, Turja et al.
>> Tumor burden is not related to quality of life
in patients with metastatic colorectal cancer, Sloan et al.
For more background information on integrating
quality-of-life measures into clinical practice, read Mayo’s two-part
monograph published in the November–December 2005 and November–December
2006 issues of Current Problems in Cancer.
NCCTG is a national clinical research group
sponsored by the National Cancer Institute. Its research and
administration are based at Mayo Clinic. NCCTG consists of cancer
specialists at community clinics, hospitals and medical centers in the
United States, Canada and Mexico. The group is dedicated to bringing
clinical trials with promising new cancer therapies to communities where
patients live.
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