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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/2387

Title: Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population: An international multicenter study
Authors: Efficace, F
Therasse, P
Piccart, MJ
Coens, C
VAN STEEN, Kristel
Welnicka-Jaskiewicz, M
Cufer, T
Dyczka, J
Lichinitser, M
Shepherd, L
de Haes, H
Sprangers, MA
Bottomley, A
Issue Date: 2004
Citation: JOURNAL OF CLINICAL ONCOLOGY, 22(16). p. 3381-3388
Abstract: Purpose The purpose of this research was to evaluate whether baseline health-related quality of life (HRQOL) parameters are prognostic factors for survival in locally advanced breast cancer patients. Although the literature highlights the important role of HRQOL parameters in predicting survival in advanced metastatic disease, little evidence exists for earlier stages. Patients and Methods The overall sample consisted of 448 patients randomly assigned to receive cyclophosphamide, epirubicin, and fluorouracil versus epirubicin, cyclophosphamide, and granulocyte colony-stimulating factor. Patients were enrolled in 12 countries. HRQOL baseline scores were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. In addition, a bootstrap resampling technique was used to assess the stability of the outcomes. Bootstrap results were then applied for model averaging purposes as a means to account for the observed model selection uncertainty. Results The final multivariate model retained inflammatory breast cancer (T4d) as the only factor predicting overall survival (OS) with a hazard ratio of 1.375 (95% CI, 1.027 to 1.840; P = .03). The presence of inflammatory breast cancer lowers the median survival time from 6.6 to 4.2 years (36% reduction). None of the preselected HRQOL variables were prognostic for OS or disease-free survival, in either the univariate or multivariate analysis. Conclusion Our findings suggest that baseline HBQOL parameters have no prognostic value in a nonmetastatic breast cancer population.
Notes: EORTC Data Ctr, Qual Life Unit, B-1200 Brussels, Belgium. Inst Jules Bordet, B-1000 Brussels, Belgium. Limburgs Univ Ctr, Diepenbeek, Belgium. Harvard Univ, Dept Biostat, Boston, MA 02115 USA. Med Univ Gdansk, Gdansk, Poland. Inst Oncol, Ljubljana, Slovenia. Med Acad Lodz, Lodz, Poland. Ctr Canc Res, Moscow, Russia. Natl Canc Inst Canada, Clin Trials Grp, Kingston, ON, Canada. Univ Amsterdam, Dept Psychol Med, NL-1012 WX Amsterdam, Netherlands.Efficace, F, EORTC Data Ctr, Qual Life Unit, Ave E Mounier 83, B-1200 Brussels, Belgium.fef@eortc.be
URI: http://hdl.handle.net/1942/2387
DOI: 10.1200/JCO.2004.02.060
ISI #: 000223323700026
ISSN: 0732-183X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2005
Appears in Collections: Research publications

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