Surviving cervical cancer: Does health-related quality of life influence survival?
Surviving cervical cancer: Does health-related quality of life influence survival?
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DOI：
10.1016/j.ygyno.2010.02.027
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
Tang, Julia
中科院分区：
文献类型：
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作者：
Ashing-Giwa, Kimlin T.;Lim, Jung-won;Tang, Julia
Objective.本研究调查了宫颈浸润癌患者健康相关生活质量（HRQOL）结果与生存状态之间的关系。这项研究是基于353多种族宫颈癌幸存者（CCS）通过加州癌症监测计划招募的数据。自变量是通过FACT-CX（FACT-G+其他项目）和SF-12测量的HRQOL。因变量为自HRQOL调查之日起的生存期。采用Kaplan-Meier估计值和单变量及多变量考克斯比例风险回归模型分析HRQOL与生存率之间的关系。在Kaplan-Meier分析中，FACT-CX功能健康评分等于或高于中位评分与总生存期改善显著相关（X-2 = 7.19; p = 0.007）。SF-12身体和心理健康部分评分观察到生存率的显著差异。在多变量考克斯回归分析中，最终模型表明，在控制医学特征后，FACT-CX总分、功能健康和其他宫颈癌关注子量表以及SF-12身体和精神成分总分显著影响生存期。然而，不包括宫颈癌特异性项目（包括平均标准化FACT-G和身体、情感和社会/家庭幸福子量表）的FACT分量表在调整协变量前后均不是生存率的预测因子。本研究的结果通过证实HRQOL结局，特别是身体、功能和心理健康维度与CCS生存率相关，推进了当前的科学知识。这些发现突出了癌症部位特定HRQOL数据的实用性，以告知心理社会和症状管理方面，以及可能延长生命的医疗随访护理实践和研究。(C)2010年爱思唯尔公司All rights reserved.
Objective. This study investigates the association between health-related quality of life (HRQOL) outcomes and survival status among a population-based cohort diagnosed with invasive cancer of the cervix uteri.Methods. This study is based on data from 353 multiethnic cervical cancer survivors (CCS) recruited through the California Cancer Surveillance Program. The independent variable is HRQOL measured by the FACT-CX (FACT-G plus additional items) and the SF-12. The dependent variable is survival from date of the HRQOL survey. Kaplan-Meier estimates and univariate and multivariate Cox Proportional Hazards Regression models were used to examine the relationship between HRQOL and survival.Results. In the Kaplan-Meier analyses, the FACT-CX functional well-being score equal to or above the median score was significantly associated with improved overall survival (X-2 = 7.19; p = 0.007). Significant differences in survival were observed for the SF-12 physical and mental health component scores. In the multivariate Cox regression analyses, the final model indicated that the FACT-CX total scores, functional well-being, and additional cervical cancer concerns subscales, and the SF-12 physical and mental component summary scores significantly influenced survival, after controlling for medical characteristics. However, the FACT components that do not include cervical cancer specific items including mean standardized FACT-G and physical, emotional, and social/family well-being subscales were not predictors of survival before and after adjustment for covariates.Conclusions. The results of this study advance the current scientific knowledge by confirming that HRQOL outcomes, in particular the physical, function and mental health dimensions are associated with survival for CCS. These findings highlight the utility of cancer site specific HRQOL data to inform the psychosocial and symptom management aspects, as well as the medical follow-up care practice and research that may extend life. (C) 2010 Elsevier Inc. All rights reserved.