Annals of Oncology Advance Access published online on March 19, 2008
Annals of Oncology, doi:10.1093/annonc/mdn064
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Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients
1 Thoracic Oncology Unit, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve
2 Department of Statistics and Epidemiology, University Institute for Clinical Research, Université de Montpellier I, Montpellier, France
* Correspondence to: Dr J.-L. Pujol, Centre Hospitalier Universitaire de Montpellier Hôpital Arnaud de Villeneuve, F-34295 Montpellier Cedex 5, France. Fax: +33 4 67 33 61 36; Fax: +33 4 67 33 61 35; E-mail: jl-pujol{at}chu-montpellier.fr
Background: Both quality of life (QoL) and comorbidity influence therapy and prognosis of non-small-cell lung cancer (NSCLC). We previously developed a lung cancer disease-specific simplified comorbidity score (SCS) and demonstrated the prognostic impact of this disease-specific instrument. This study aimed at validating the SCS in a prospective bicentric NSCLC population by measuring its relative prognostic determinant impact taking into account well-established variables such as QoL, performance status (PS), Charlson comorbidity index (CCI) and disease stage.
Patients and methods: Prognostic values of different pretherapeutic features were tested in univariate and multivariate analyses in a population of 301 NSCLC.
Results: Median survival was 17 months. One-third of patients reporting difficulties in their normal daily activities and an overall poor QoL. The following pretreament variables were independent determinants of a shorter overall survival: advanced disease, SCS, Lung Cancer Symptoms Scale global symptoms score, anaemia, hyponatremia, serum alkaline phosphatases level, serum CYFRA 21-1 and serum neuron-specific enolase.
Conclusion: In this extended validation population, the SCS is more informative than the CCI in predicting NSCLC patient outcome as the former is also more disease specific. Combination of both SCS comorbidity score and LSCC QoL yields a more accurate information that conventional analysis of PS.
comorbidities, non-small-cell lung cancer, prognosis, quality of life
Present address: Respiratory Diseases Unit, Hôpital Saint Joseph, 6, rue de la Duchère, B-6060 Gilly, Belgium. Received for publication January 23, 2008. Accepted for publication February 14, 2008.
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