Association of health-related quality of life with overall survival in older americans with kidney cancer: A population-based cohort study

Naleen Raj Bhandari, Mohamed H. Kamel, Erin E. Kent, Carrie McAdam-Marx, Songthip T. Ounpraseuth, J. Mick Tilford, Nalin Payakachat

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: 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. Methods: We analyzed a longitudinal cohort (n = 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. Results: 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)). Conclusions: 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.

Original languageEnglish (US)
Article number1344
JournalHealthcare (Switzerland)
Volume9
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • Health-related quality of life
  • Kidney cancer
  • Longitudinal
  • Overall survival
  • SEER-MHOS

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Health Informatics
  • Health Information Management

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