title: The utility of abbreviated patient-reported outcomes for predicting survival in early stage colorectal cancer.
abstract: Patient-reported outcomes (PROs) are increasingly used in clinical settings. Prior research suggests that PROs collected at baseline may be associated with cancer survival, but most of those studies were conducted in patients with breast or lung cancer. The objective of this study was to determine the correlation between prospectively collected PROs and cancer-specific outcomes in patients with early stage colorectal cancer.
  
  
  
  Patients who had newly diagnosed stage II or III colorectal cancer from 2009 to 2010 and had a consultation at the British Columbia Cancer Agency completed the brief Psychosocial Screen for Cancer (PSSCAN) questionnaire, which collects data on patients' perceived social supports, quality of life (QOL), anxiety and depression, and general health. PROs from the PSSCAN were linked with the Gastrointestinal Cancers Outcomes Database, which contains information on patient and tumor characteristics, treatment details, and cancer outcomes. Cox regression models were constructed for overall survival (OS), and Fine and Gray regression models were developed for disease-specific survival (DSS).
  
  
  
  In total, 692 patients were included. The median patient age was 67 years (range, 26-95 years), and the majority had colon cancer (61%), were diagnosed with stage III disease (54%), and received chemotherapy (58%). In general, patients felt well supported and reported good overall health and QOL. On multivariate analysis, increased fatigue was associated with worse OS (hazard ratio [HR], 1.99; P = .00007) and DSS (HR, 1.63; P = .03), as was lack of emotional support (OS: HR, 4.36; P = .0003; DSS: HR, 1.92; P = .02).
  
  
  
  Although most patients described good overall health and QOL and indicated that they were generally well supported, patients who experienced more pronounced fatigue or lacked emotional support had a higher likelihood of worse OS and DSS. These findings suggest that abbreviated PROs can inform and assist clinicians to identify patients who have a worse prognosis and may need more vigilant follow-up. Cancer 2017;123:1839-1847. © 2017 American Cancer Society.
authors.affiliation: Department of Medical Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Tina
authors.initials: T
authors.lastname: Hsu
authors.affiliation: Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Caroline H
authors.initials: CH
authors.lastname: Speers
authors.affiliation: Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
authors.forename: Hagen F
authors.initials: HF
authors.lastname: Kennecke
authors.affiliation: Department of Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Winson Y
authors.initials: WY
authors.lastname: Cheung
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D015996:Survival Rate
keywords: colorectal cancer; early stage; patient-reported outcomes; survival