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Among patients with advanced non–small cell lung cancer, patient-reported pain and difficulty swallowing were each linked with worse survival. These results were published in the Annals of Oncology.

Lung cancer remains the leading cause of cancer death in the U.S. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 75%–80% of all lung cancers.

For patients with cancer, an increasing amount of research attention is being paid to health-related quality of life. Health-related quality of life refers to several measures of physical, emotional, and social functioning. Measurement of health-related quality of life may be used to track the effects of cancer treatment on a patient’s well-being, and may also provide information about cancer prognosis.

To explore the relationship between pre-treatment health-related quality of life and survival, researchers in Europe evaluated information from 391 patients with Stage IIIB or Stage IV NSCLC.

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  • Among the various measures of quality of life, the two that were significantly linked with survival were pain and difficulty swallowing (dysphagia). On a scale of 0 to 100, each 10-point increase in patient-reported pain was linked with an 11% increase in risk of death. A 10-point increase in the severity of patient-reported dysphagia was linked with a 12% increase in risk of death.
  • Other predictors of survival were gender and performance status (a measure of disability). Females and patients with a better performance status had better survival.
  • Based on information about a patient’s pain, dysphagia, gender, and performance status, the researchers developed a prognostic index that divided patients into three prognostic groups. One-year survival ranged from 18% among patients in the worst prognostic group to 50% among patients in the best prognostic group.

The researchers conclude that pain and difficulty swallowing were linked with worse survival among patients with advanced NSCLC. The researchers note that collection of information about health-related quality of life may aid in clinical decision making by providing important prognostic information.

Reference: Efficace F, Bottomley A, Smit EF et al. Is a Patient’s Self-reported Health-related Quality of Life a Prognostic Factor for Survival in Non-small-cell Lung Cancer Patients? A Multivariate Analysis of Prognostic Factors of EORTC Study 08975. Annals of Oncology. 2006;17:1698-1704.

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