Quality of life assessment as a prognostic tool in breast cancer

Abstract

6122 Background: While the use of quality of life (QoL) assessments has been increasing in the clinical oncology community, few studies have examined the prognostic significance of QoL in breast cancer. To examine this issue, we investigated the association between baseline QoL and survival in breast cancer. Methods: A case series of 105 patients with stages I-IV breast cancer treated at Cancer Treatment Centers of America® at Midwestern Regional Medical Center between March 2001 and October 2003 were included in this study. QoL was evaluated using the EORTC QLQ-C30 (EORTC) and the Ferrans and Powers Quality of Life Index (QLI). Patients were dichotomized into two groups based on the median scores for all QoL domains. Kaplan Meier method was used to evaluate survival. Log-Rank test was used to study the equality of survival distributions across strata. Results: Patients with QLI health function scores above the median (17.65) had an overall median survival of 22.8 months, compared to those with scores below the median, 15.74 months (p = 0.004). Similarly, patients with global health EORTC scores above the median (58.33) had an overall median survival of 23.21 months compared to 11.57 months for those with scores below the median (p=0.002). Both associations retained statistical significance even after controlling for tumor stage (QLI health function, p = 0.003 and EORTC global health, p = 0.001). Conclusion: This study suggests that baseline QoL can provide useful prognostic information in breast cancer. Further studies should focus on more extensive evaluation of the prognostic significance of QoL in the cancer treatment setting. No significant financial relationships to disclose.