Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients.
BACKGROUND
Both quality of life (QoL) and comorbidity influence therapy and prognosis of non-small-cell lung cancer (NSCLC). We previously developed a lung cancer disease-specific simplified comorbidity score (SCS) and demonstrated the prognostic impact of this disease-specific instrument. This study aimed at validating the SCS in a prospective bicentric NSCLC population by measuring its relative prognostic determinant impact taking into account well-established variables such as QoL, performance status (PS), Charlson comorbidity index (CCI) and disease stage.


METHODS
Prognostic values of different pretherapeutic features were tested in univariate and multivariate analyses in a population of 301 NSCLC.


RESULTS
Median survival was 17 months. One-third of patients reporting difficulties in their normal daily activities and an overall poor QoL. The following pretreament variables were independent determinants of a shorter overall survival: advanced disease, SCS, Lung Cancer Symptoms Scale global symptoms score, anaemia, hyponatremia, serum alkaline phosphatases level, serum CYFRA 21-1 and serum neuron-specific enolase.


CONCLUSIONS
In this extended validation population, the SCS is more informative than the CCI in predicting NSCLC patient outcome as the former is also more disease specific. Combination of both SCS comorbidity score and LSCC QoL yields a more accurate information that conventional analysis of PS.
Jacot
W
W
Thoracic Oncology Unit, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve.
Colinet
B
B
Thoracic Oncology Unit, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve.
Bertrand
D
D
Thoracic Oncology Unit, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve.
Lacombe
S
S
Department of Statistics and Epidemiology, University Institute for Clinical Research, Université de Montpellier I, Montpellier, France.
Bozonnat
M-C
MC
Department of Statistics and Epidemiology, University Institute for Clinical Research, Université de Montpellier I, Montpellier, France.
Daurès
J-P
JP
Department of Statistics and Epidemiology, University Institute for Clinical Research, Université de Montpellier I, Montpellier, France.
Pujol
J-L
JL
Thoracic Oncology Unit, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve; Department of Statistics and Epidemiology, University Institute for Clinical Research, Université de Montpellier I, Montpellier, France. Electronic address: jl-pujol@chu-montpellier.fr.
D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D015996:Survival Rate