Determinants of quality of life in patients with incurable cancer

dc.check.date2021-04-08
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorDaly, Louise E.
dc.contributor.authorDolan, Ross D.
dc.contributor.authorPower, Derek G.
dc.contributor.authorNí Bhuachalla, Éadaoin
dc.contributor.authorSim, Wei
dc.contributor.authorCushen, Samantha J.
dc.contributor.authorFallon, Marie
dc.contributor.authorSimmons, Claribel
dc.contributor.authorMcMillan, Donald C.
dc.contributor.authorLaird, Barry J.
dc.contributor.authorRyan, Aoife M.
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2020-07-10T09:59:54Z
dc.date.available2020-07-10T09:59:54Z
dc.date.issued2020-04-08
dc.date.updated2020-07-10T09:32:31Z
dc.description.abstractBackground: 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDaly, 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.32824en
dc.identifier.doi10.1002/cncr.32824en
dc.identifier.eissn1097-0142
dc.identifier.endpage2882en
dc.identifier.issn0008-543X
dc.identifier.issued12en
dc.identifier.journaltitleCanceren
dc.identifier.startpage2872en
dc.identifier.urihttps://hdl.handle.net/10468/10229
dc.identifier.volume126en
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc. on behalf of The American Cancer Societyen
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2273/IE/Alimentary Pharmabiotic Centre (APC) - Interfacing Food & Medicine/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.subjectIncurable canceren
dc.subjectPalliative careen
dc.subjectPerformance scoreen
dc.subjectQuality of lifeen
dc.subjectSystemic inflammationen
dc.subjectWeight lossen
dc.titleDeterminants of quality of life in patients with incurable canceren
dc.typeArticle (peer-reviewed)en
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