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Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea

Cancer Research and Treatment 2019년 51권 4호 p.1600 ~ 1611
 ( Mai Tran Thi Xuan ) - National Cancer Center Graduate School of Cancer Science and Policy Department of Cancer Control and Population Health

 ( Choi Jin-Hyuk ) - National Cancer Center Research Institute and Hospital Center for Breast Cancer
 ( Lee Myung-Kyung ) - Kyungpook National University College of Nursing
 ( Chang Yoon-Jung ) - National Cancer Center Graduate School of Cancer Science and Policy Department of Cancer Control and Population Health
 ( Jung So-Youn ) - National Cancer Center Research Institute and Hospital Center for Breast Cancer
 ( Cho Hyun-Soon ) - National Cancer Center Graduate School of Cancer Science and Policy Department of Cancer Control and Population Health
 ( Lee Eun-Sook ) - National Cancer Center Research Institute and Hospital Center for Breast Cancer

Abstract


Purpose: We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital.

Materials and Methods: Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors.

Results: Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83).

Conclusion: Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.

키워드

Breast neoplasms; Quality of life; Overall survival
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