The relationship between health utility, quality of life, and symptom scores in Canadian patients with esophageal cancer.

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149 Background: Health Utility scores (HUS) are an increasingly important tool in helping to determine the cost-effectiveness of therapies worldwide. The EQ-5D is a validated HUS questionnaire, with reference data in numerous populations. Previously, HUS in esophageal cancer (EC) were based on limited datasets, and the relationship between HUS and either quality of life (QOL, through the validated FACT-E) or esophageal-specific symptoms such as dysphagia, has not been studied. Methods: This cross-sectional survey of EC patients at Princess Margaret Cancer Centre (2012-2014) assessed EQ-5D, FACT-E, a Visual Analog Scale (VAS), patient reported performance status (PRO-ECOG), and dysphagia scoring. EQ-5D scores were converted to HUS using Canadian references. Correlation analyses were performed between HUS and global FACT-E scores, global dysphagia scores, and specific esophageal symptom scores included in FACT-E. Results: Of 198 patients, median age was 67 (range 32-93) years, 76% were male, with localized (LD stage 1, 6%), regional (RD, stage II-IVA, 62%), and metastatic (MD, stage IVB, 27%) disease. Mean + SEM EQ-5D HUS was 0.80+0.01 (all patients), 0.90+0.05 (LD), 0.82+0.01 (RD), and 0.73+0.03 (MD) [p=0.03]. Mean FACT-E total score was 130, mean total FACT-G score was 80, and mean ECS score was 49. There was a strong correlation between FACT-E total scores and EQ-5D HUS (r=0.73, p<0.001), and mild-to-moderate correlation between FACT-E dysphagia questions and HUS (r= 0.28-0.37; p<0.001, each comparison) and between the odynophagia question and HUS (r=0.28, p<0.001). A moderate correlation was observed between a non-FACT-E based global swallow score and HUS (r=0.48, p<0.001). Conclusions: In this large cross-sectional study of EC patients, stage, QOL, and esophageal-specific symptoms were all associated with HUS. Additional results will be presented on the relationship of VAS, PRO-ECOG and specific FACT-E domains, with HUS and changes in questionnaire scores over time, as well as stage-specific EC reference HUS using UK and USA references. This research enhances our understanding of the factors driving EQ5D HUS in EC, thereby validating its potential usefulness in economic analyses.