Bhandari Naleen Raj, Kamel Mohamed H, Kent Erin E, McAdam-Marx Carrie, Ounpraseuth Songthip T, Tilford J Mick, Payakachat Nalin
Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA.
Department of Urology, University of Cincinnati, Cincinnati, OH 45221, USA.
Healthcare (Basel). 2021 Oct 10;9(10):1344. doi: 10.3390/healthcare9101344.
Our purpose was to evaluate associations between health-related quality of life (HRQoL) and overall survival (OS) in a population-based sample of kidney cancer (KC) patients in the US.
We analyzed a longitudinal cohort ( = 188) using the Surveillance, Epidemiology, and End Results (SEER) database linked with the Medicare Health Outcomes Survey (MHOS; 1998-2014). We included KC patients aged ≥65 years, with a completed MHOS during baseline (pre-diagnosis) and another during follow-up (post-diagnosis). We reported HRQoL as physical component summary (PCS) and mental component summary (MCS) scores and OS as number of months from diagnosis to death/end-of-follow-up. Findings were reported as adjusted hazard ratios (aHRs (95% CI)) from Cox Proportional Hazard models.
The aHRs associated with a 3-point lower average (baseline and follow-up) or a 3-point within-patient decline (change) in HRQoL with OS were: (a) baseline: PCS (1.08 (1.01-1.16)) and MCS (1.09 (1.01-1.18)); (b) follow-up: PCS (1.21 (1.12-1.31)) and MCS (1.11 (1.04-1.19)); and (c) change: PCS (1.10 (1.02-1.18)) and MCS (1.02 (0.95-1.10)).
Reduced HRQoL was associated with worse OS and this association was strongest for post-diagnosis PCS, followed by change in PCS and pre-diagnosis PCS. Findings highlight the prognostic value of HRQoL on OS, emphasize the importance of monitoring PCS in evaluating KC prognosis, and contribute additional evidence to support the implementation of patient-reported outcomes in clinical settings.
我们的目的是评估美国肾癌（KC）患者的基于人群样本中健康相关生活质量（HRQoL）与总生存期（OS）之间的关联。
我们使用与医疗保险健康结果调查（MHOS；1998 - 2014年）相链接的监测、流行病学和最终结果（SEER）数据库分析了一个纵向队列（n = 188）。我们纳入了年龄≥65岁的KC患者，他们在基线（诊断前）和随访（诊断后）期间均完成了MHOS。我们将HRQoL报告为身体成分总结（PCS）和心理成分总结（MCS）得分，将OS报告为从诊断到死亡/随访结束的月数。研究结果报告为Cox比例风险模型的调整风险比（aHRs（95%CI））。
与HRQoL平均降低3分（基线和随访）或患者内降低3分（变化）相关的OS的aHRs为：（a）基线：PCS（1.08（1.01 - 1.16））和MCS（1.09（1.01 - 1.18））；（b）随访：PCS（1.21（1.12 - 1.31））和MCS（1.11（1.04 - 1.19））；以及（c）变化：PCS（1.10（1.02 - 1.18））和MCS（1.02（0.95 - 1.10））。
HRQoL降低与更差的OS相关，这种关联在诊断后PCS中最强，其次是PCS变化和诊断前PCS。研究结果突出了HRQoL对OS的预后价值，强调了在评估KC预后时监测PCS的重要性，并为支持在临床环境中实施患者报告结局提供了额外证据。
