Patient Satisfaction with Health-Related Quality of Life: Implications for Prognosis in Prostate Cancer

Abstract

Purpose The goal of this study was to evaluate the association between patient satisfaction with health-related quality of life (HRQOL), as measured by the Ferrans and Powers Quality of Life Index (QLI), and survival in patients with prostate cancer treated in an integrative cancer treatment setting. Materials and Methods This is a case series of 230 histologically confirmed stage I-IV prostate cancers treated at Cancer Treatment Centers of America. Quality of Life Index measures overall HRQOL and HRQOL in 4 major subscales: health and physical, social and economic, psychological and spiritual, and family. Study patients were dichotomized into 2 groups based on the median scores for all QLI subscales. Kaplan- Meier and log-rank tests were used to evaluate survival. Multivariate Cox regression analyses were then performed to evaluate the joint prognostic significance of HRQOL and clinical factors. Results Patient satisfaction with health and physical ( P = .0001), psychological and spiritual ( P = .03), family ( P = .02), and overall HRQOL ( P = .0001) were statistically significantly associated with survival upon univariate analysis. Upon multivariate analysis, patient satisfaction with the health and physical subscale was found to be predictive of survival ( P = .04), independent of the effects of previous treatment history and Gleason score. Conclusion This study suggests that baseline patient satisfaction with health and physical function, as measured by the QLI, provides useful prognostic information in patients with prostate cancer, independent of previous treatment history and Gleason score. The QLI Index can be used as a stratification variable in the oncology clinic to aid in medical decision-making.