Determinants of quality of life in patients with incurable cancer

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dc.contributor.author Daly, Louise E.
dc.contributor.author Dolan, Ross D.
dc.contributor.author Power, Derek G.
dc.contributor.author Ní Bhuachalla, Éadaoin
dc.contributor.author Sim, Wei
dc.contributor.author Cushen, Samantha J.
dc.contributor.author Fallon, Marie
dc.contributor.author Simmons, Claribel
dc.contributor.author McMillan, Donald C.
dc.contributor.author Laird, Barry J.
dc.contributor.author Ryan, Aoife M.
dc.date.accessioned 2020-07-10T09:59:54Z
dc.date.available 2020-07-10T09:59:54Z
dc.date.issued 2020-04-08
dc.identifier.citation Daly, L. E., Dolan, R. D., Power, D. G., Ní Bhuachalla, É., Sim, W., Cushen, S. J., Fallon, M., Simmons, C., McMillan, D. C., Laird, B. J. and Ryan, A. M. (2020) 'Determinants of quality of life in patients with incurable cancer', Cancer, 126(12), pp. 2872-2882. doi: 10.1002/cncr.32824 en
dc.identifier.volume 126 en
dc.identifier.issued 12 en
dc.identifier.startpage 2872 en
dc.identifier.endpage 2882 en
dc.identifier.issn 0008-543X
dc.identifier.uri http://hdl.handle.net/10468/10229
dc.identifier.doi 10.1002/cncr.32824 en
dc.description.abstract Background: Optimizing quality of life (QoL) remains the central tenet of care in patients with incurable cancer; however, determinants of QoL are not clear. The objective of the current study was to examine which factors influence QoL in patients with incurable cancer. Methods: A multicenter study of adult patients with advanced cancer was conducted in Ireland and the United Kingdom between 2011 and 2016. Data were collected from patients at study entry and included patient demographics, Eastern Cooperative Oncology Group performance status (ECOG‐PS), nutritional parameters (the percentage weight loss [%WL]), muscle parameters assessed using computed tomography images (skeletal muscle index and skeletal muscle attenuation), inflammatory markers (modified Glasgow Prognostic score [mGPS]), and QoL data (the European Organization for Research and Treatment Quality‐of‐Life Questionnaire C‐30). The relation between clinical, nutritional, and inflammatory parameters with QoL was assessed using the Spearman rank correlation coefficient and multivariate binary logistic regression. Components of the European Organization for Research and Treatment Quality‐of‐Life Questionnaire C‐30 (physical function, fatigue, and appetite loss) and summary QoL scores were mean‐dichotomized for the logistic regression analyses. Results: Data were available for 1027 patients (51% men; median age, 66 years). Gastrointestinal cancer was most prevalent (40%), followed by lung cancer (26%) and breast cancer (9%). Distant metastatic disease was present in 87% of patients. The %WL, ECOG‐PS, and mGPS were significantly correlated with deteriorating QoL functional and symptom scales (all P < .001). On multivariate regression analysis, >10% WL (odds ratio [OR], 2.69; 95% CI, 1.63‐4.42), an ECOG‐PS of 3 or 4 (OR, 14.33; 95% CI, 6.76‐30.37), and an mGPS of 2 (OR, 1.58; 95% CI, 1.09‐2.29) were independently associated with poorer summary QoL scores. These parameters were also independently associated with poorer physical function, fatigue, and appetite loss (all P < .05). Low skeletal muscle attenuation was independently associated with poorer physical functioning (OR, 1.67; 95% CI, 1.09‐2.56), but muscle parameters were not independently associated with fatigue, appetite loss, or QoL summary scores. Conclusions: The current findings indicate that QoL is determined (at least in part) by WL, ECOG‐PS, and the systemic inflammatory response in patients with advanced cancer. Identifying early predictors of poor QoL may allow the identification of patients who may benefit from early referral to palliative and supportive care, which has been shown to improve QoL. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Inc. on behalf of The American Cancer Society en
dc.rights © 2020, American Cancer Society. Published by John Wiley & Sons, Inc. This is the peer reviewed version of the following article: Daly, L. E., Dolan, R. D., Power, D. G., Ní Bhuachalla, É., Sim, W., Cushen, S. J., Fallon, M., Simmons, C., McMillan, D. C., Laird, B. J. and Ryan, A. M. (2020) 'Determinants of quality of life in patients with incurable cancer', Cancer, 126(12), pp. 2872-2882, doi: 10.1002/cncr.32824, which has been published in final form at https://doi.org/10.1002/cncr.32824. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. en
dc.subject Incurable cancer en
dc.subject Palliative care en
dc.subject Performance score en
dc.subject Quality of life en
dc.subject Systemic inflammation en
dc.subject Weight loss en
dc.title Determinants of quality of life in patients with incurable cancer en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Samantha Cushen, Food and Nutritional Sciences, University College Cork, Cork, Ireland. +353-21-490-3000 Email: samantha.cushen@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-04-08
dc.date.updated 2020-07-10T09:32:31Z
dc.description.version Accepted Version en
dc.internal.rssid 524186218
dc.contributor.funder Science Foundation Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Cancer en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress samantha.cushen@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2273/IE/Alimentary Pharmabiotic Centre (APC) - Interfacing Food & Medicine/ en
dc.identifier.eissn 1097-0142


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