title: Quality of Life in Patients With Advanced Cancer: Differential Association With Performance Status and Systemic Inflammatory Response.
abstract: Quality of life is a key component of cancer care; however, the factors that determine quality of life are not well understood. The aim of this study was to examine the relationship between quality of life parameters, performance status (PS), and the systemic inflammatory response in patients with advanced cancer.
  
  
  
  An international biobank of patients with advanced cancer was analyzed. Quality of life was assessed at a single time point by using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (EORTC QLQ-C30). PS was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. Systemic inflammation was assessed by using the modified Glasgow Prognostic Score (mGPS), which combines C-reactive protein and albumin. The relationship between quality of life parameters, ECOG PS, and the mGPS was examined.
  
  
  
  Data were available for 2,520 patients, and the most common cancers were GI (585 patients [22.2%]) and pulmonary (443 patients [17.6%]). The median survival was 4.25 months (interquartile range, 1.36 to 12.9 months). Increasing mGPS (systemic inflammation) and deteriorating PS were associated with deterioration in quality-of-life parameters (P < .001). Increasing systemic inflammation was associated with deterioration in quality-of-life parameters independent of PS.
  
  
  
  Systemic inflammation was associated with quality-of-life parameters independent of PS in patients with advanced cancer. Further investigation of these relationships in longitudinal studies and investigations of possible effects of attenuating systemic inflammation are now warranted.
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom. barry.laird@ed.ac.uk.
authors.forename: Barry J A
authors.initials: BJ
authors.lastname: Laird
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Marie
authors.initials: M
authors.lastname: Fallon
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tuck
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Pål
authors.initials: P
authors.lastname: Klepstad
authors.affiliation: Barry J.A. Laird, Marianne J. Hjermstad, Stein Kaasa, and Pål Klepstad, Norwegian University of Science and Technology; Pål Klepstad, Trondheim University Hospital, Trondheim; Marianne J. Hjermstad and Stein Kaasa, Oslo University Hospital, Oslo, Norway; Barry J.A. Laird, Marie Fallon, and Sharon Tuck, University of Edinburgh, Edinburgh; and Donald C. McMillan, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D000368:Aged; D001066:Appetite; D002097:C-Reactive Protein / Q000378:metabolism; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000209:etiology; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life; D012720:Severity of Illness Index; D012890:Sleep; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein