title: Prognostic value of quality of life scores in patients with oesophageal cancer
abstract: AIMS: Quality of life (QL) data are useful in evaluating treatment, in screening or psychosocial morbidity and there is accumulating evidence to show that they predict survival. This study investigated if baseline QL scores are prognostic for patients with oesophageal cancer. METHODS: Between 1993 and 1995, 89 consecutive new patients with oesophageal cancer completed baseline QL assessments with the EORTC QLQ-C30 questionnaire and the dysphagia scale from the oesophageal cancer module. Cox's proportional hazards models were used to assess the impact of QL variables on survival (82 patients have died). RESULTS: Univariate analyses revealed that better baseline physical and role function scores were significantly associated with increased survival (P </= 0.001) and worse fatigue, appetite loss and constipation scores were significantly associated with shorter survival (P < 0.01). Multivariate analysis, taking account of associations between the QL scores and adjusting for age, tumour node metastasis classification T, N and M stage, showed that only physical function at baseline remained significantly associated with survival (P = 0.002); adjusting for sex, histology and comorbid disease did not alter the findings. CONCLUSIONS: There is evidence to suggest that QL parameters may be important prognostic factors for patients with oesophageal cancer. Stronger evidence may be gained from a more highly powered study, and further understanding of the associations between QL variables and clinical data is needed.
authors.affiliation: University Department of Surgery, Bristol Royal Infirmary and Department of Social Medicine, University of Bristol, Bristol, UK.
authors.initials: JM
authors.lastname: Blazeby
authors.initials: ST
authors.lastname: Brookes
authors.initials: D
authors.lastname: Alderson