title: Can anorexia predict patient satisfaction with quality of life in advanced cancer?
abstract: OBJECTIVE
  Anorexia is the second most common symptom after fatigue in patients with advanced cancer. We quantified the relationship between anorexia and patient satisfaction with quality of life (QoL) in advanced cancer.
  
  
  METHODS
  A case series of 954 cancer patients treated at the Cancer Treatment Centers of America. Anorexia was measured using the QLQ-C30 loss of appetite/anorexia subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between anorexia and QLI was evaluated using multivariate analysis of variance and multiple regression analysis.
  
  
  RESULTS
  Of 954 patients, 579 were females and 375 males with the median age at presentation of 56 years. Of these patients, 66% had failed prior treatment. Most common cancers were breast (26%), colorectal (19%), and lung (16%). After controlling for the effects of age, treatment history, and other QLQ-C30 symptom subscales, every 10 unit increase in anorexia was statistically significantly associated with 0.18 unit decline in QLI health and physical function score.
  
  
  CONCLUSIONS
  We found that anorexia is significantly correlated with patient satisfaction with health and physical function in advanced cancer. Future studies should evaluate the impact of integrative cancer care services on patient satisfaction with QoL.
authors.affiliation: Cancer Treatment Centers of America, Midwestern Regional Medical Center, Zion, IL 60099, USA. christopher.lis@ctca-hope.com
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Lis
authors.forename: Digant
authors.initials: D
authors.lastname: Gupta
authors.forename: James F
authors.initials: JF
authors.lastname: Grutsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009369:Neoplasms / Q000150:complications; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult