title: Prognostic value of health-related quality-of-life parameters in early-stage breast cancer: an 8-year follow-up study.
abstract: OBJECTIVE
  The purpose was to investigate whether self-reported health-related quality-of-life (HRQOL) parameters at time of diagnosis and/or 1-year follow-up are prognostic for disease-free survival (DFS) in early-stage breast cancer patients.
  
  
  METHODS
  Data from 195 women, diagnosed with early-stage breast cancer, who had filled in the EORTC QLQ-C30 and the Hospital Anxiety and Depression Scale (HADS) at time of diagnosis and 1 year after surgery, were analyzed.
  
  
  RESULTS
  After a median follow-up of 8.2 years (range 0.09-9.45), 27 (14.1%) deaths and 22 (11.5%) recurrences were observed. Using Cox multivariate regression analysis, appetite loss reported 1-year following surgery (HR 2.92, 95% CI 1.50-5.66), p=0.002) was significantly predictive for shorter DFS, even after controlling for age and depression. None of the clinical or biological prognostic factors was found to have a confounding effect.
  
  
  CONCLUSIONS
  The findings indicate that loss of appetite probably is of prognostic value in addition to well-recognized clinical and biological data, in early-stage breast cancer.
authors.affiliation: Breast and Endocrine Surgical Unit, Oslo University Hospital, Oslo, Norway. IngerSchou.Bredal@ulleval.no
authors.forename: Inger Schou
authors.initials: IS
authors.lastname: Bredal
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Rolf
authors.initials: R
authors.lastname: Karesen
authors.forename: Oivind
authors.initials: O
authors.lastname: Ekeberg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001066:Appetite; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D016019:Survival Analysis; D055815:Young Adult