title: Determinants of overall quality of life in preterminal cancer patients.
abstract: Recently, a few studies reported that fatigue was a predominant contributor to patient-perceived overall QoL in patients with different types of cancer in a relatively early stage of disease. In the present study, we aimed to investigate whether fatigue is also a major contributor to overall QoL in preterminal cancer patients. Ninety-eight preterminal cancer patients, mainly lung (44%) and gastrointestinal cancer (25%), with an estimated life expectancy of 1-6 months were included. QoL domains as well as overall QoL were measured using the EORTC QLQ-C30 questionnaire. Data were analysed by Pearson's correlations and multivariate modelling. Fatigue showed the strongest correlation with overall QoL (r = -0.63, p < 0.001), followed in decreasing order by role functioning (r = 0.53), physical functioning (r = 0.47), social functioning (r = 0.44), nausea (r = -0.37), cognitive functioning (r = 0.33), appetite loss (r = -0.31), dyspnea (r = -0.26) and emotional functioning (r = 0.24). Multivariate analysis confirmed that the fatigue scale paid by far the highest individual contribution to overall QoL (standardized regression coefficient (SRC): -0.41, p = 0.002), followed by social functioning (SRC: 0.18, p = 0.05). None of the other domains or symptom scales contributed independently to overall QoL. Our results clearly demonstrate that, in preterminal cancer patients, fatigue is a major contributor of overall QoL, corroborating reports in cancer patients in earlier disease stages.
authors.affiliation: Department of Epidemiology, NUTRIM, Maastricht University, Maastricht, The Netherlands. sandra.beijer@epid.unimaas.nl
authors.forename: Sandra
authors.initials: S
authors.lastname: Beijer
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
authors.forename: Madelon C G
authors.initials: MC
authors.lastname: Pijls-Johannesma
authors.forename: Alexander
authors.initials: A
authors.lastname: de Graeff
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000209:etiology; D003071:Cognition; D003967:Diarrhea / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D004644:Emotions; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009325:Nausea / Q000209:etiology; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012380:Role; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000209:etiology
chemical_list: D000255:Adenosine Triphosphate