TY - JOUR
T1 - Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma
AU - Deng, Yang
AU - Tu, Huakang
AU - Pierzynski, Jeanne A.
AU - Miller, Ethan D.
AU - Gu, Xiangjun
AU - Huang, Maosheng
AU - Chang, David W.
AU - Ye, Yuanqing
AU - Hildebrandt, Michelle A.T.
AU - Klein, Alison P.
AU - Zhao, Ren
AU - Lippman, Scott M.
AU - Wu, Xifeng
N1 - Funding Information:
This work was supported by the funds collected pursuant to the Comprehensive Tobacco Settlement to the University of Texas MD Anderson Cancer Center. Additional funding was provided by the Center for Translational and Public Health Genomics , Dan Duncan Family Institute for Risk Assessment and Cancer Prevention and MD Anderson's Cancer Center Support Grant from the National Cancer Institute at the National Institutes of Health [ P30, CA016672 ]. Dr. Klein is supported by the National Cancer Institute at the National Institutes of Health [ P50, CA062924 ].
Funding Information:
This work was supported by the funds collected pursuant to the Comprehensive Tobacco Settlement to the University of Texas MD Anderson Cancer Center. Additional funding was provided by the Center for Translational and Public Health Genomics, Dan Duncan Family Institute for Risk Assessment and Cancer Prevention and MD Anderson's Cancer Center Support Grant from the National Cancer Institute at the National Institutes of Health [P30, CA016672]. Dr. Klein is supported by the National Cancer Institute at the National Institutes of Health [P50, CA062924].
Publisher Copyright:
© 2017
PY - 2018/3
Y1 - 2018/3
N2 - Background: Quality of life (QOL) is impaired in pancreatic cancer patients. Our aim was to investigate the determinants and prognostic value of QOL after diagnosis in a hospital-based cohort of racially/ethnically diverse patients with pancreatic ductal adenocarcinoma (PDAC). Patients and methods: QOL was prospectively assessed using the Short Form-12 in 2478 PDAC patients. The Physical Component Summary (PCS) and Mental Component Summary (MCS) were categorised into tertiles based on their distribution. Ordered logistic regression was adopted to compare the risk of having lower PCS and MCS by patient sociodemographic and clinical characteristics. The association of PCS and MCS with mortality was assessed by Cox regression. Results: Compared with non-Hispanic whites, Hispanics were at significantly higher risk of having lower PCS (odds ratio [95% CI], 1.69 [1.26–2.26]; P < 0.001) and lower MCS (1.66 [1.24–2.23]; P < 0.001). Patients diagnosed with stage III (1.80 [1.10–2.94]; P = 0.02) and stage IV (2.32 [1.50–3.59]; P < 0.001) PDAC were more likely to have lower PCS than stage I patients. Other determinants of QOL included sex, age, drinking, smoking, education level, comorbidities and time since diagnosis. The low tertile of PCS (hazard ratio [95% CI], 1.94 [1.72–2.18]; P < 0.001) and MCS (1.42 [1.26–1.59]; P < 0.001) were each related to poor prognosis. Similar results were found for non-Hispanic whites as compared with African-Americans/Hispanics/others. Conclusion: QOL after diagnosis is a significant prognostic indicator for patients with PDAC. Multiple factors determine QOL, suggesting possible means of intervention to improve QOL and outcomes of PDAC patients.
AB - Background: Quality of life (QOL) is impaired in pancreatic cancer patients. Our aim was to investigate the determinants and prognostic value of QOL after diagnosis in a hospital-based cohort of racially/ethnically diverse patients with pancreatic ductal adenocarcinoma (PDAC). Patients and methods: QOL was prospectively assessed using the Short Form-12 in 2478 PDAC patients. The Physical Component Summary (PCS) and Mental Component Summary (MCS) were categorised into tertiles based on their distribution. Ordered logistic regression was adopted to compare the risk of having lower PCS and MCS by patient sociodemographic and clinical characteristics. The association of PCS and MCS with mortality was assessed by Cox regression. Results: Compared with non-Hispanic whites, Hispanics were at significantly higher risk of having lower PCS (odds ratio [95% CI], 1.69 [1.26–2.26]; P < 0.001) and lower MCS (1.66 [1.24–2.23]; P < 0.001). Patients diagnosed with stage III (1.80 [1.10–2.94]; P = 0.02) and stage IV (2.32 [1.50–3.59]; P < 0.001) PDAC were more likely to have lower PCS than stage I patients. Other determinants of QOL included sex, age, drinking, smoking, education level, comorbidities and time since diagnosis. The low tertile of PCS (hazard ratio [95% CI], 1.94 [1.72–2.18]; P < 0.001) and MCS (1.42 [1.26–1.59]; P < 0.001) were each related to poor prognosis. Similar results were found for non-Hispanic whites as compared with African-Americans/Hispanics/others. Conclusion: QOL after diagnosis is a significant prognostic indicator for patients with PDAC. Multiple factors determine QOL, suggesting possible means of intervention to improve QOL and outcomes of PDAC patients.
KW - Overall survival
KW - Pancreatic ductal adenocarcinoma
KW - Prognostic indicator
KW - Quality of life
KW - Short Form-12
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U2 - 10.1016/j.ejca.2017.12.023
DO - 10.1016/j.ejca.2017.12.023
M3 - Article
C2 - 29413686
AN - SCOPUS:85041587414
SN - 0959-8049
VL - 92
SP - 20
EP - 32
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -