Abstract
PurposeWe aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL.MethodsABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods.ResultsA total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = − 0.106, p = 0.3136).ConclusionWithin this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.
Highlights
Advanced breast cancer (ABC), defined as metastatic breast cancer, is a major cause of death among women worldwide [1]
Previous studies have shown that the quality of life (QoL) of these patients is positively associated with response to antitumor treatment, time to progression, and survival, but
There are different questionnaires suitable for evaluation of QoL among patients with ABC ranging from disease specific tools such as the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to more generic instruments that allow comparison of QoL across diseases
Summary
Advanced breast cancer (ABC), defined as metastatic breast cancer (stage IV), is a major cause of death among women worldwide [1]. Despite improving outcome of patients with ABC due to the introduction of new treatment agents and strategies, the disease remains largely incurable [2,3,4]. Previous studies have shown that the quality of life (QoL) of these patients is positively associated with response to antitumor treatment, time to progression, and survival, but Extended author information available on the last page of the article negatively associated with toxicity [5,6,7,8]. It is essential to report on QoL in addition to clinical parameters to determine the health benefit of a new treatment. There are different questionnaires suitable for evaluation of QoL among patients with ABC ranging from disease specific tools such as the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to more generic instruments that allow comparison of QoL across diseases. The EQ-5D is the most widely used generic instrument to obtain such an utility score that reflects the overall health-state of
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