Quality of life as a potential predictor for morbidity and mortality in patients with metastatic hormone-refractory prostate cancer.
BACKGROUND
The association between HRQL measures with outcomes in patients with metastatic hormone-refractory prostate cancer (HRPC) is unclear.


METHODS
Baseline and 12-week HRQL was collected using the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy - Prostate (FACT-P). Outcomes included: (1) survival; (2) time to disease progression and (3) time to bone pain. Cox proportional hazards regression models were used. The relative predictive performance of each HRQL instrument and domain was compared.


RESULTS
Baseline HRQL scores and 12-week change scores > the median were significant predictors of all clinical outcomes but varied by domain. For example, the hazard of death for a change in FACT-P Grand Total Score > median was 49% of the hazard for a change < or = the median. Including baseline or 12-week change in HRQL resulted in improvement in prediction performance.


CONCLUSIONS
Patients with better baseline HRQL have better predicted survival, time to disease progression and pain prognosis than those with worse HRQL. In addition, the 12-week change in HRQL appears to improve predictive accuracy for most clinical outcomes. It appears that greater deterioration in HRQL is prognostic for rapid disease progression.
Sullivan
Patrick W
PW
Pharmaceutical Outcomes Research Program, University of Colorado School of Pharmacy, Denver, CO 80262, USA. Patrick.Sullivan@UCHSC.edu
Nelson
Joel B
JB
Mulani
Parvez M
PM
Sleep
Darryl
D
D000368:Aged; D017326:Clinical Trials, Phase III as Topic; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005544:Forecasting; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D011788:Quality of Life; D018434:Sickness Impact Profile; D016019:Survival Analysis