title: Relationship between deficits in overall quality of life and non-small-cell lung cancer survival.
abstract: OBJECTIVE
  Evidence has suggested a clinically meaningful relationship between self-reported quality of life (QOL) of a patient with cancer at the time of receiving a cancer diagnosis and overall survival (OS). This study evaluated the prognostic value of QOL assessments with regard to OS in a large cohort of patients with lung cancer.
  
  
  METHODS
  A total of 2,442 patients with non-small-cell lung cancer were observed between 1997 and 2007 and completed a single-item measure of overall QOL within the first 6 months of receiving a lung cancer diagnosis; these were dichotomized using an a priori definition of a clinically deficient score (CDS; ≤ 50 v > 50). Kaplan-Meier estimates and Cox models were used to evaluate the prognostic importance of QOL on OS alone and in the presence of covariates. Logistic regression modeling was used to identify which clinical and patient characteristics were related to a clinically meaningful deficit in QOL.
  
  
  RESULTS
  QOL deficits at time of lung cancer diagnosis were significantly associated with OS (hazard ratio [HR], 1.55; P < .001), as were performance status, older age, smoking history, male sex, treatment factors, and stage of disease. The median survival for patients with CDS QOL was 1.6 years versus 5.6 years for patients with non-CDS QOL. After controlling for all these covariates, the indication of a clinically deficient baseline QOL still contributed significantly to the prediction of patient survival (HR, 0.67; P < .001).
  
  
  CONCLUSIONS
  Overall QOL measured by a simple single item at the time of lung cancer diagnosis is a significant and independent prognostic factor for survival in patients with lung cancer.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA. jsloan@mayo.edu
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Xinghua
authors.initials: X
authors.lastname: Zhao
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Jason
authors.initials: J
authors.lastname: Wampfler
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Garces
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors