Health-Related Quality of Life in a Predictive Model for Mortality in Older Breast Cancer Survivors.

DuMontier, Clark; Clough-Gorr, Kerri M; Silliman, Rebecca A; Stuck, Andreas; Moser, André (2018). Health-Related Quality of Life in a Predictive Model for Mortality in Older Breast Cancer Survivors. Journal of the American Geriatrics Society, 66(6), pp. 1115-1122. Wiley-Blackwell 10.1111/jgs.15340

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OBJECTIVES To develop a predictive model and risk score for 10-year mortality using health-related quality of life (HRQOL) in a cohort of older women with early-stage breast cancer. DESIGN Prospective cohort. SETTING Community. PARTICIPANTS U.S. women aged 65 and older diagnosed with Stage I to IIIA primary breast cancer (N=660). MEASUREMENTS We used medical variables (age, comorbidity), HRQOL measures (10-item Physical Function Index and 5-item Mental Health Index from the Medical Outcomes Study (MOS) 36-item Short-Form Survey; 8-item Modified MOS Social Support Survey), and breast cancer variables (stage, surgery, chemotherapy, endocrine therapy) to develop a 10-year mortality risk score using penalized logistic regression models. We assessed model discriminative performance using the area under the receiver operating characteristic curve (AUC), calibration performance using the Hosmer-Lemeshow test, and overall model performance using Nagelkerke R(NR). RESULTS Compared to a model including only age, comorbidity, and cancer stage and treatment variables, adding HRQOL variables improved discrimination (AUC 0.742 from 0.715) and overall performance (NR 0.221 from 0.190) with good calibration (p=0.96 from HL test). CONCLUSION In a cohort of older women with early-stage breast cancer, HRQOL measures predict 10-year mortality independently of traditional breast cancer prognostic variables. These findings suggest that interventions aimed at improving physical function, mental health, and social support might improve both HRQOL and survival.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic > Geriatric Clinic Inselspital
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Clough, Kerri; Stuck, Andreas and Moser, André

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0002-8614

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

22 Mar 2018 11:33

Last Modified:

06 Sep 2018 08:02

Publisher DOI:

10.1111/jgs.15340

PubMed ID:

29533469

Uncontrolled Keywords:

geriatric oncology health-related quality of life, breast cancer, survivorship, prediction

BORIS DOI:

10.7892/boris.113073

URI:

https://boris.unibe.ch/id/eprint/113073

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