EuroQol and survival prediction in terminal cancer patients: a multicenter prospective study in hospice-palliative care units.
OBJECTIVE
Although the EuroQol (EQ-5D) is widely used for economic evaluation, it remains unclear whether it can be combined with medical data to predict survival in patients with terminal cancer.


METHODS
We carried out this prospective study on 142 terminal cancer patients in four hospice-palliative care units. Association was sought between survival time and a range of variables such as cancer site, performance, previous treatment, age, sex, pain, and EuroQol. The EQ-5D was transformed into the corresponding EQ-5D utility. For univariate analysis, we estimated differences in survival with the Gehan generalized Wilcoxon test. For those variables that were significant, we performed multivariate analysis using the Cox proportional hazard model.


RESULTS
Univariate analysis showed that sex, age, performance, previous use of chemotherapy, and the EQ-5D utility provided statistically significant prognostic survival information. The median survival time was 13.0 days for the group with an EQ-5D utility score lower than -0.5 and 21.0 days for the group with an EQ-5D utility score above -0.5. In multivariate analysis with the Cox proportional hazard model, an EQ-5D utility score < or = 0.5 (RR 1.57, 95% confidence interval 1.06-2.33) was an independent negative predictor of survival.


CONCLUSIONS
The EQ-5D quality-of-life assessment tool might be useful for predicting survival time for terminal cancer patients.
Park
Sang Min
SM
Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang, Gyeonggi, 411-769, South Korea.
Park
Myung Hee
MH
Won
Joo Hee
JH
Lee
Kyoung Ok
KO
Choe
Wha Sook
WS
Heo
Dae Seog
DS
Kim
Si-Young
SY
Lee
Kyung Sik
KS
Yun
Young Ho
YH
D000368:Aged; D005260:Female; D006738:Hospices; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010166:Palliative Care; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D013534:Survival; D019452:Terminally Ill