Determinants of quality of life in patients with incurable cancer

Daly, Louise E.; Dolan, Ross D.; Power, Derek G.; Ní Bhuachalla, Éadaoin; Sim, Wei; Cushen, Samantha J.; Fallon, Marie; Simmons, Claribel; McMillan, Donald C.; Laird, Barry J.; Ryan, Aoife M.

Determinants of quality of life in patients with incurable cancer

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.contributor.funder	Science Foundation Ireland	en
dc.date.accessioned	2020-07-10T09:59:54Z
dc.date.available	2020-07-10T09:59:54Z
dc.date.issued	2020-04-08
dc.date.updated	2020-07-10T09:32:31Z
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.description.status	Peer reviewed	en
dc.description.version	Accepted Version	en
dc.format.mimetype	application/pdf	en
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.doi	10.1002/cncr.32824	en
dc.identifier.eissn	1097-0142
dc.identifier.endpage	2882	en
dc.identifier.issn	0008-543X
dc.identifier.issued	12	en
dc.identifier.journaltitle	Cancer	en
dc.identifier.startpage	2872	en
dc.identifier.uri	https://hdl.handle.net/10468/10229
dc.identifier.volume	126	en
dc.language.iso	en	en
dc.publisher	John Wiley & Sons, Inc. on behalf of The American Cancer Society	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.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