Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients
Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients
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DOI：
10.1093/annonc/mdn064
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发表时间：
2008-08-01
影响因子：
50.5
通讯作者：
Pujol, J. -L.
中科院分区：
文献类型：
--
作者：
Jacot, W.;Colinet, B.;Pujol, J. -L.
背景：生活质量（QoL）和合并症影响非小细胞肺癌（NSCLC）的治疗和预后。我们以前开发了一种肺癌疾病特异性简化合并症评分（SCS），并证明了这种疾病特异性工具的预后影响。本研究旨在通过测量SCS的相对预后决定因素影响，并考虑到已确立的变量，如生活质量、体能状态（PS）、Charlson合并症指数（CCI）和疾病分期，在前瞻性双中心NSCLC人群中验证SCS。患者和方法：在301例NSCLC人群中，采用单变量和多变量分析测试不同治疗前特征的预后值。中位生存期为17个月。三分之一的患者报告日常活动困难，总体生活质量较差。以下治疗前变量是总生存期较短的独立决定因素：晚期疾病、SCS、肺癌症状量表总体症状评分、贫血、低钠血症、血清碱性磷酸酶水平、血清CYFRA 21-1和血清神经元特异性烯醇化酶。在该扩展验证人群中，SCS在预测NSCLC患者结局方面比CCI提供更多信息，因为前者也更具疾病特异性。SCS合并症评分和LSCC QoL的结合比传统的PS分析提供了更准确的信息。
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.