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Health-Related Quality of Life in a Predictive Model for Mortality in Older Breast Cancer Survivors
- Source :
- Journal of the American Geriatrics Society. 66:1115-1122
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- 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.
- Subjects :
- medicine.medical_specialty
Framingham Risk Score
business.industry
medicine.disease
Logistic regression
Comorbidity
03 medical and health sciences
0302 clinical medicine
Breast cancer
Geriatric oncology
Quality of life
030220 oncology & carcinogenesis
Internal medicine
Cohort
medicine
030212 general & internal medicine
Geriatrics and Gerontology
Prospective cohort study
business
Subjects
Details
- ISSN :
- 00028614
- Volume :
- 66
- Database :
- OpenAIRE
- Journal :
- Journal of the American Geriatrics Society
- Accession number :
- edsair.doi...........d5aeaa4fad1e45ba49de43a21d9f6149