title: Prevalence, intensity, and prognostic significance of common symptoms in terminally ill cancer patients.
abstract: BACKGROUND
  Quality of life and palliative management of end-stage cancer patients should improve with greater understanding of the prevalence, intensity, and prognostic significance of their symptoms.
  
  
  OBJECTIVE
  We investigated the association between prevalence and intensity of common symptoms and overall survival in Chinese end-stage cancer patients.
  
  
  METHODS
  For this cross-sectional study, 163 Chinese patients with end-stage cancer completed an Edmonton Symptom Assessment questionnaire, and each was given a Karnofsky Performance Status (KPS) score. Overall survival was estimated via the Kaplan-Meier method. Factors affecting overall survival were determined by univariate and multivariate Cox regression analyses.
  
  
  RESULTS
  Mean survival of these patients was 51 days. Pain, lack of appetite, and poor well-being were the most frequent symptoms, in 90.2%, 88.3%, and 87.7%, respectively. The most severe symptoms were fatigue, lack of appetite, drowsiness, and poor well-being. Fatigue, lack of appetite, drowsiness, shortness of breath, poor well-being, depression, and KPS score significantly affected overall survival rate, with a relative risk of dying of 1.560, 2.320, 1.684, 1.295, 1.912, 1.414, and 0.487, respectively (Cox regression coefficients: 0.361, 0.827, 0.539, 0.185, 0.694, 0.318, and -0.602). Fatigue, lack of appetite, shortness of breath, age, and KPS score were independent risk factors of overall survival, with a relative risk of dying of 1.581, 1.122, 1.123, 1.022, and 0.797, respectively (Cox regression coefficients: 0.458, 0.115, 0.116, 0.022, and -0.227).
  
  
  CONCLUSIONS
  Fatigue, shortness of breath, lack of appetite, age, and KPS score were associated with overall survival of end-stage Chinese cancer patients.
authors.affiliation: Department of Medical Oncology, Xuzhou Hospital Affiliated to Medical College of Southeast University and Xuzhou Central Hospital, Xuzhou, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Na
authors.forename: Chao
authors.initials: C
authors.lastname: Ma
authors.forename: Wei-Ling
authors.initials: WL
authors.lastname: Huo
authors.forename: Liang
authors.initials: L
authors.lastname: Han
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Qing-Song
authors.initials: QS
authors.lastname: Xi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000145:classification / Q000473:pathology / Q000503:physiopathology*; D010166:Palliative Care / Q000458:organization & administration / Q000592:standards*; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D019452:Terminally Ill; D055815:Young Adult