title: Relation between tumor size, quality of life, and survival in patients with colorectal liver metastases.
abstract: OBJECTIVE
  This study assessed the relationship between survival, tumor size, and quality of life (QoL; Rotterdam Symptom Checklist [RSC], Hospital Anxiety and Depression Scale [HAD], and Sickness Impact Profile [SIP]) in 50 patients with colorectal liver metastases (CLM).
  
  
  RESULTS
  Physical symptom score (RSC) was a stronger survival predictor than tumor size measured on computed tomographic (CT) scan. The best model for predicting survival included QoL questions about diarrhea, eating, restlessness, and ability to work and sleep. The only clinically measured variable included in this best survival prediction model was serum alkaline phosphatase level. This is the first study to show that QoL indices predict survival in CLM. The findings suggest that differences in tumor products and not just in tumor size could influence patient fitness and survival in CLM. Such differences are more accurately estimated by QoL assessment than measurement of tumor size.
  
  
  CONCLUSIONS
  QoL provides a better survival estimate than measurement of tumor size and could be used as a surrogate end point for survival in treatment trials.
authors.affiliation: Department of Surgery, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Earlam
authors.forename: C
authors.initials: C
authors.lastname: Glover
authors.forename: C
authors.initials: C
authors.lastname: Fordy
authors.forename: D
authors.initials: D
authors.lastname: Burke
authors.forename: T G
authors.initials: TG
authors.lastname: Allen-Mersh
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001007:Anxiety / Q000523:psychology; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000523:psychology; D003863:Depression / Q000523:psychology; D006801:Humans; D017567:Karnofsky Performance Status; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000523:psychology / Q000556:secondary*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology; D009367:Neoplasm Staging; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D015431:Weight Loss / Q000502:physiology
chemical_list: D000469:Alkaline Phosphatase