Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry

Anouk K M Claessens, Bram L T Ramaekers, Dorien J A Lobbezoo, Roel J W van Kampen, Maaike de Boer, Agnes J van de Wouw, M Wouter Dercksen, Sandra M E Geurts, Manuela A Joore, Vivianne C G Tjan-Heijnen, Anouk K M Claessens, Bram L T Ramaekers, Dorien J A Lobbezoo, Roel J W van Kampen, Maaike de Boer, Agnes J van de Wouw, M Wouter Dercksen, Sandra M E Geurts, Manuela A Joore, Vivianne C G Tjan-Heijnen

Abstract

Purpose: We aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL.

Methods: ABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods.

Results: A total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = - 0.106, p = 0.3136).

Conclusion: Within this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.

Keywords: Advanced breast cancer; EQ-5D; Health utilities; Quality of life; Real-world.

Conflict of interest statement

A.K.M. Claessens: nothing to declare. B.L.T. Ramaekers: nothing to declare. D.J.A. Lobbezoo: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003); Novartis BV; Roche; Pfizer. R.J.W. van Kampen: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003). M. de Boer: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003); Novartis BV; Roche; Pfizer; Eisai; Eli Lilly. A.J. van de Wouw: nothing to declare. M.W. Dercksen: nothing to declare. S.M.E. Geurts: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003); Novartis BV; Roche; Pfizer; Eli Lilly. M.A. Joore: nothing to declare. V.C.G. Tjan-Heijnen: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003); Novartis BV; Roche; Pfizer; Eisai; E. Lilly.

Figures

Fig. 1
Fig. 1
Utility versus time after metastatic disease diagnosis for the whole cohort (black line, r = -0.11 p = 0.3136) and by age subgroups < 65 years (red line, r = 0.19 p = 0.1365) versus ≥ 65 years (blue line, r = 0.04 p = 0.8323). (Color figure online)
Fig. 2
Fig. 2
Utility versus time to death*, for the whole cohort (black line, r = 0.26 p = 0.0252) and by age subgroups < 65 years (red line, r = 0.34 p = 0.0159) versus ≥ 65 years (blue line, r = 0.17 p = 0.4304). *Only patients who deceased during the observation period were included. Two patients were still alive at last follow-up and were excluded from these analyses. (Color figure online)

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