TY - JOUR
T1 - The prognostic value of patient-reported Health-Related Quality of Life and Geriatric Assessment in predicting early death in 6769 older (≥70 years) patients with different cancer tumors
AU - Quinten, Chantal
AU - Kenis, Cindy
AU - Decoster, Lore
AU - Debruyne, Philip R.
AU - De Groof, Inge
AU - Focan, Christian
AU - Cornelis, Frank
AU - Verschaeve, Vincent
AU - Bachmann, Christian
AU - Bron, Dominique
AU - Luce, Syvlie
AU - Debugne, Gwenaëlle
AU - Van den Bulck, Heidi
AU - Goeminne, Jean Charles
AU - Schrijvers, Dirk
AU - Geboers, Katrien
AU - Petit, Benedicte
AU - Langenaeken, Christine
AU - Van Rijswijk, Ruud
AU - Specenier, Pol
AU - Jerusalem, Guy
AU - Praet, Jean Philippe
AU - Vandenborre, Katherine
AU - Lycke, Michelle
AU - Flamaing, Johan
AU - Milisen, Koen
AU - Lobelle, Jean Pierre
AU - Wildiers, Hans
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Objectives: We aimed to determine the prognostic value of baseline Health-Related Quality Of Life (HRQOL) and geriatric assessment (GA) to predict three-month mortality in older patients with cancer undergoing treatment. Methods: Logistic regressions analysed HRQOL, as measured with the EORTC Global Health Status (GHS) scale, and geriatric information prognostic for early mortality controlling for oncology variables. The assessment was established with the odds ratio (OR), 95% confidence interval (CI) and level of significance set at p < 0.05. Discriminative power was evaluated with area under the curve (AUC). Results: In total, 6769 patients were included in the study, of whom 1259 (18.60%) died at three months. Our model showed higher odds of early death for patients with lower HRQOL (GHS, OR 0.98, 95% CI 0.98–0.99; p < 0.001), a geriatric risk profile (G8 Screening Tool, 1.94, 1.14–3.29; p = 0.014), cognitive decline (Mini Mental State Examination, 1.41, 1.15–1.72; p = 0.001), being at risk for malnutrition (Mini Nutritional Assessment–Short Form, 1.54, 1.21–1.98; p = 0.001), fatigue (Visual Analogue Scale for Fatigue, 1.45, 1.16–1.82; p = 0.012) and comorbidities (Charlson Comorbidity index, 1.23, 1.02–1.49; p = 0.033). Additionally, older age, poor ECOG PS and being male increased the odds of early death, although the magnitude differed depending on tumor site and stage, and treatment (all p < 0.05). Predictive accuracy increased with 3.7% when including HRQOL and GA in the model. Conclusion: The results suggest that, in addition to traditional clinical measures, HRQOL and GA provide additional prognostic information for early death, but the odds differ by patient and tumor characteristics.
AB - Objectives: We aimed to determine the prognostic value of baseline Health-Related Quality Of Life (HRQOL) and geriatric assessment (GA) to predict three-month mortality in older patients with cancer undergoing treatment. Methods: Logistic regressions analysed HRQOL, as measured with the EORTC Global Health Status (GHS) scale, and geriatric information prognostic for early mortality controlling for oncology variables. The assessment was established with the odds ratio (OR), 95% confidence interval (CI) and level of significance set at p < 0.05. Discriminative power was evaluated with area under the curve (AUC). Results: In total, 6769 patients were included in the study, of whom 1259 (18.60%) died at three months. Our model showed higher odds of early death for patients with lower HRQOL (GHS, OR 0.98, 95% CI 0.98–0.99; p < 0.001), a geriatric risk profile (G8 Screening Tool, 1.94, 1.14–3.29; p = 0.014), cognitive decline (Mini Mental State Examination, 1.41, 1.15–1.72; p = 0.001), being at risk for malnutrition (Mini Nutritional Assessment–Short Form, 1.54, 1.21–1.98; p = 0.001), fatigue (Visual Analogue Scale for Fatigue, 1.45, 1.16–1.82; p = 0.012) and comorbidities (Charlson Comorbidity index, 1.23, 1.02–1.49; p = 0.033). Additionally, older age, poor ECOG PS and being male increased the odds of early death, although the magnitude differed depending on tumor site and stage, and treatment (all p < 0.05). Predictive accuracy increased with 3.7% when including HRQOL and GA in the model. Conclusion: The results suggest that, in addition to traditional clinical measures, HRQOL and GA provide additional prognostic information for early death, but the odds differ by patient and tumor characteristics.
UR - http://www.scopus.com/inward/record.url?scp=85083299021&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2020.03.017
DO - 10.1016/j.jgo.2020.03.017
M3 - Article
C2 - 32305251
AN - SCOPUS:85083299021
SN - 1879-4068
VL - 11
SP - 926
EP - 936
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 6
ER -