title: Quality of life assessment as a predictor of survival in non-small cell lung cancer.
abstract: BACKGROUND
  There are conflicting and inconsistent results in the literature on the prognostic role of quality of life (QoL) in cancer. We investigated whether QoL at admission could predict survival in lung cancer patients.
  
  
  METHODS
  The study population consisted of 1194 non-small cell lung cancer patients treated at our institution between Jan 2001 and Dec 2008. QoL was evaluated using EORTC-QLQ-C30 prior to initiation of treatment. Patient survival was defined as the time interval between the date of first patient visit and the date of death from any cause/date of last contact. Univariate and multivariate Cox regression evaluated the prognostic significance of QoL.
  
  
  RESULTS
  Mean age at presentation was 58.3 years. There were 605 newly diagnosed and 589 previously treated patients; 601 males and 593 females. Stage of disease at diagnosis was I, 100; II, 63; III, 348; IV, 656; and 27 indeterminate. Upon multivariate analyses, global QoL as well as physical function predicted patient survival in the entire study population. Every 10-point increase in physical function was associated with a 10% increase in survival (95% CI = 6% to 14%, p < 0.001). Similarly, every 10-point increase in global QoL was associated with a 9% increase in survival (95% CI = 6% to 11%, p < 0.001). Furthermore, physical function, nausea/vomiting, insomnia, and diarrhea (p < 0.05 for all) in newly diagnosed patients, but only physical function (p < 0.001) in previously treated patients were predictive of survival.
  
  
  CONCLUSIONS
  Baseline global QoL and physical function provide useful prognostic information in non-small cell lung cancer patients.
authors.affiliation: Cancer Treatment Centers of America® at Midwestern Regional Medical Center, Zion, IL 60099, USA.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Braun
authors.forename: Digant
authors.initials: D
authors.lastname: Gupta
authors.forename: Edgar D
authors.initials: ED
authors.lastname: Staren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D011795:Surveys and Questionnaires