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We aimed to clarify the association of breast cancer patients’ clinical experiences with patient-reported outcomes (PRO) of satisfaction with care, choice of the same type of surgery again, and health-related quality of life (HRQOL). There were 2,403 (25.9%) of 9,283 eligible women who had undergone primary curative surgery for breast cancer in one of five selected hospitals between 1993 and 2002 who responded to a survey questionnaire including information about care experiences, satisfaction with care, and HRQOL. Treatment satisfaction was independently associated with cancer recurrence, problems obtaining surgery, receiving adjuvant hormonal therapy, being involved in treatment decisions, having opinions reflected in treatment decisions, experiencing treatment toxicity, or being hospitalized for treatment toxicity ( P <0.01). Breast-conserving surgery with radiotherapy, receiving adjuvant hormone therapy, being involved in treatment decisions, having opinion reflected in treatment decisions, having no treatment toxicity, and receiving regular follow-up care were associated with choosing the same treatment over again ( P < 0.01). Good care experiences, except for regular follow-ups, were significantly associated with good HRQOL in most functioning subscales ( P < 0.01). Our findings suggest that timely referral for treatment, reflection of the patient’s opinions in treatment decisions, and prevention of treatment toxicity might be important to HRQOL. [ABSTRACT FROM AUTHOR]

Although some studies suggest that conformity with consensus recommendations for breast cancer therapy is associated with increased survival, the data are not clear. We identified patients in four hospital-based breast cancer registries in Korea who had undergone primary curative surgery (stage 0-III) from 1993 through 2002 (n = 8,407). We collected demographic and clinical characteristics such as age, stage, treatment, and hormone receptor status. We gathered 1993-2004 mortality data by linkage to the National Statistical Office. During the follow-up period of 43,145 person-years (mean, 5.13 years), we identified 899 deceased cases. We used the standard Poisson regression model to estimate the hazard ratio (HR) for survival in relation to conformity with guidelines for chemo-, hormone, and locoregional therapy. Guideline compliance for systemic therapy increased from 24.0% in 1993 to 83.8% in 2002. Among mastectomy patients with <4 positive lymph nodes and tumors <5 cm, postmastectomy radiotherapy was associated with poor survival (HR 2.07; 95% CI: 1.53-2.81). Tamoxifen use was associated with better survival among patients with hormone receptor-positive tumors (HR 0.57; 95% CI: 0.45-0.73) and with poorer survival among hormone receptor-negative patients who had affected nodes (HR 1.58; 95% CI: 1.01-2.44). Relative to conformity, non-conformity with both chemo- and hormone therapy guidelines was associated with a 76% higher risk of death. Compliance with consensus recommendations for chemo- and hormone therapy is significantly associated with better survival. Overuse of post-mastectomy radiotherapy and tamoxifen beyond the consensus recommendations may be harmful. [ABSTRACT FROM AUTHOR]

Previous studies about the quality of life (QOL) in stomach cancer survivors focused on selected clinical parameters and did not consider the broader implications for overall health and QOL. We evaluated the impact of demographic and treatment-related factors on the QOL of stomach cancer survivors. We asked 391 stage I–III stomach cancer survivors who had been disease-free for at least 1 year after surgery to complete a demographic questionnaire, the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire, and its stomach module, QLQ-STO22. Survivors undergoing total gastrectomy reported greater eating restrictions than those undergoing subtotal gastrectomy. Receiving chemotherapy or radiotherapy did not significantly affect any QLQ-C30 or QLQ-STO22 scores. Role and emotional functioning improved with increasing age, and stomach-specific symptoms (pain, eating restrictions, and anxiety) lessened. Compared with female survivors, male survivors had better physical and role functioning. Smoking status was also a significant negative predictor of physical functioning and anxiety. Comorbidities and selected demographic characteristics had a greater effect than type of treatment on the QOL of post-operative stomach cancer patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to develop and evaluate the internal consistency and construct validity of a Korean version of the Caregiver Quality of Life Index - Cancer (CQOLC-K).Methods: The CQOLC-K was administered to 270 caregivers, along with the Medical Outcomes Study Short Form-36 (SF-36) and the Beck Depression Inventory (BDI).Results: Internal consistency of the CQOLC-K (0.90) and all inter-scale correlations were significant in the expected direction (p<0.001). Convergent validity was supported with moderate to strong correlations between the CQOLC-K and the mental component scores of the SF-36 (r= 0.39-0.58), and between the CQOLC-K and the two BDI scores (r= 0.50 and 0.60). Divergent validity was supported by weaker or negligible correlations between the CQOLC-K and the physical component scores of the SF-36 (r= 0.16-0.30). Contrasting groups validity showed that the CQOLC-K was able to distinguish clearly between patients differing in treatment history (p<0.005), performance status (p<0.005), care area (p<0.005), and length of time after diagnosis (p<0.005).Conclusion: These findings support the internal consistency reliability and construct validity of the Korean version of the CQOLC-K. The instrument can be used to measure quality of life in caregivers of cancer patients in clinical and epidemiological research. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the psychometric properties of the Korean version of the European Organization for Research and Treatment of Cancer Breast-Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). A total of 153 patients with breast cancer and 153 normal subjects completed three questionnaires of the Korean version of the EORTC QLQ-BR23. Multitrait scaling analyses demonstrated that all scales met multidimensional conceptualization criteria in terms of convergence and discrimination validity. Cronbach?s alpha coefficients for five multiple-item scales were greater than 0.70 (range, 0.72?0.91). In known-group comparisons, there were marked group differences between patients differing in disease stage. In breast cancer patients, performance on the questionnaires was in the expected direction for almost all functioning and symptom scores. In addition, comparison between the patient and control groups showed that almost all variables discriminated between patients and normal individuals. In conclusion, the Korean version of the EORTC QLQ-BR23 was found to be a reliable and valid measure of quality of life in breast cancer patients, indicating that it should be used in clinical and epidemiological cancer research. [ABSTRACT FROM AUTHOR]