Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer
Background Previous studies have established that higher baseline quality of life (QOL) scores are associated with improved survival in patients with metastatic colorectal cancer (mCRC). We examined the relationship between overall survival (OS) and baseline QOL. Patients and Methods A total of 1 24...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-06-01
|
| Series: | Cancer Control |
| Online Access: | https://doi.org/10.1177/10732748231185047 |
| _version_ | 1797688147959611392 |
|---|---|
| author | Patrick McGarrah MD Joleen Hubbard MD Paul J. Novotny MS Megan E. Branda MS Daniel S. Sargent PhD Roscoe F. Morton MD Charles S. Fuchs MD Al B. Benson MD Stephen K. Williamson MD Brian P. Findlay MD Steven R. Alberts MD, MPH Richard M. Goldberg MD Jeff A. Sloan PhD |
| author_facet | Patrick McGarrah MD Joleen Hubbard MD Paul J. Novotny MS Megan E. Branda MS Daniel S. Sargent PhD Roscoe F. Morton MD Charles S. Fuchs MD Al B. Benson MD Stephen K. Williamson MD Brian P. Findlay MD Steven R. Alberts MD, MPH Richard M. Goldberg MD Jeff A. Sloan PhD |
| author_sort | Patrick McGarrah MD |
| collection | DOAJ |
| description | Background Previous studies have established that higher baseline quality of life (QOL) scores are associated with improved survival in patients with metastatic colorectal cancer (mCRC). We examined the relationship between overall survival (OS) and baseline QOL. Patients and Methods A total of 1 247 patients with mCRC participating in N9741 (comparing bolus 5-FU/LV, irinotecan [IFL] vs infusional 5-FU/leucovorin [LV]/oxaliplatin [FOLFOX] vs. irinotecan/oxaliplatin [IROX]) provided data at baseline on overall QOL using a single-item linear analogue self-assessment (LASA) 0–100 point scale. The association of OS according to clinically deficient (defined as CD-QOL, score 0–50) vs not clinically deficient (nCD-QOL, score 51–100) baseline QOL scores was tested. A multivariable analysis using Cox proportional hazards modeling was performed to adjust for the effects of multiple baseline factors. An exploratory analysis was performed evaluating OS according to baseline QOL status among patients who did or did not receive second-line therapy. Results Baseline QOL was a strong predictor of OS for the whole cohort (CD-QOL vs nCD-QOL: 11.2 months vs 18.4 months, P < .0001), and in each arm IFL 12.4 vs 15.1 months, FOLFOX 11.1 months vs 20.6 months, and IROX 8.9 months vs 18.1 months. Baseline QOL was associated with baseline performance status (PS) ( P < .0001). After adjusting for PS and treatment arm, baseline QOL was still associated with OS ( P = .017). Conclusions Baseline QOL is an independent prognostic factor for OS in patients with mCRC. The demonstration that patient-assessed QOL and PS are independent prognostic indicators suggests that these assessments provide important complementary prognostic information. |
| first_indexed | 2024-03-12T01:27:05Z |
| format | Article |
| id | doaj.art-3d9a8dee7cba4816a2b94d26e85684fe |
| institution | Directory Open Access Journal |
| issn | 1526-2359 |
| language | English |
| last_indexed | 2024-03-12T01:27:05Z |
| publishDate | 2023-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cancer Control |
| spelling | doaj.art-3d9a8dee7cba4816a2b94d26e85684fe2023-09-12T13:34:00ZengSAGE PublishingCancer Control1526-23592023-06-013010.1177/10732748231185047Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal CancerPatrick McGarrah MDJoleen Hubbard MDPaul J. Novotny MSMegan E. Branda MSDaniel S. Sargent PhDRoscoe F. Morton MDCharles S. Fuchs MDAl B. Benson MDStephen K. Williamson MDBrian P. Findlay MDSteven R. Alberts MD, MPHRichard M. Goldberg MDJeff A. Sloan PhDBackground Previous studies have established that higher baseline quality of life (QOL) scores are associated with improved survival in patients with metastatic colorectal cancer (mCRC). We examined the relationship between overall survival (OS) and baseline QOL. Patients and Methods A total of 1 247 patients with mCRC participating in N9741 (comparing bolus 5-FU/LV, irinotecan [IFL] vs infusional 5-FU/leucovorin [LV]/oxaliplatin [FOLFOX] vs. irinotecan/oxaliplatin [IROX]) provided data at baseline on overall QOL using a single-item linear analogue self-assessment (LASA) 0–100 point scale. The association of OS according to clinically deficient (defined as CD-QOL, score 0–50) vs not clinically deficient (nCD-QOL, score 51–100) baseline QOL scores was tested. A multivariable analysis using Cox proportional hazards modeling was performed to adjust for the effects of multiple baseline factors. An exploratory analysis was performed evaluating OS according to baseline QOL status among patients who did or did not receive second-line therapy. Results Baseline QOL was a strong predictor of OS for the whole cohort (CD-QOL vs nCD-QOL: 11.2 months vs 18.4 months, P < .0001), and in each arm IFL 12.4 vs 15.1 months, FOLFOX 11.1 months vs 20.6 months, and IROX 8.9 months vs 18.1 months. Baseline QOL was associated with baseline performance status (PS) ( P < .0001). After adjusting for PS and treatment arm, baseline QOL was still associated with OS ( P = .017). Conclusions Baseline QOL is an independent prognostic factor for OS in patients with mCRC. The demonstration that patient-assessed QOL and PS are independent prognostic indicators suggests that these assessments provide important complementary prognostic information.https://doi.org/10.1177/10732748231185047 |
| spellingShingle | Patrick McGarrah MD Joleen Hubbard MD Paul J. Novotny MS Megan E. Branda MS Daniel S. Sargent PhD Roscoe F. Morton MD Charles S. Fuchs MD Al B. Benson MD Stephen K. Williamson MD Brian P. Findlay MD Steven R. Alberts MD, MPH Richard M. Goldberg MD Jeff A. Sloan PhD Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer Cancer Control |
| title | Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer |
| title_full | Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer |
| title_fullStr | Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer |
| title_full_unstemmed | Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer |
| title_short | Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer |
| title_sort | baseline quality of life is a strong and independent prognostic factor for overall survival in metastatic colorectal cancer |
| url | https://doi.org/10.1177/10732748231185047 |
| work_keys_str_mv | AT patrickmcgarrahmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT joleenhubbardmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT pauljnovotnyms baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT meganebrandams baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT danielssargentphd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT roscoefmortonmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT charlessfuchsmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT albbensonmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT stephenkwilliamsonmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT brianpfindlaymd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT stevenralbertsmdmph baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT richardmgoldbergmd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer AT jeffasloanphd baselinequalityoflifeisastrongandindependentprognosticfactorforoverallsurvivalinmetastaticcolorectalcancer |