Limits...
Retrospective study of the effect of disease progression on patient reported outcomes in HER-2 negative metastatic breast cancer patients.

Walker MS, Hasan M, Yim YM, Yu E, Stepanski EJ, Schwartzberg LS - Health Qual Life Outcomes (2011)

Bottom Line: Mean age was 57 years, with 72% of patients Caucasian, and 25% African American.Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores.In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.

View Article: PubMed Central - HTML - PubMed

Affiliation: ACORN Research, LLC, 6555 Quince, Suite 400, Memphis, TN 38119, USA. mwalker@acorncro.com

ABSTRACT

Background: This retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs) that assess symptom burden and health related quality of life (HRQoL) in women with metastatic breast cancer (mBC).

Methods: HER-2 negative mBC patients (n = 102) were enrolled from 7 U.S. community oncology practices. Demographic, disease and treatment characteristics were abstracted from electronic medical records and linked to archived Patient Care Monitor (PCM) assessments. The PCM is a self-report measure of symptom burden and HRQoL administered as part of routine care in participating practices. Linear mixed models were used to examine change in PCM scores over time.

Results: Mean age was 57 years, with 72% of patients Caucasian, and 25% African American. Median time from mBC diagnosis to first disease progression was 8.8 months. Metastasis to bone (60%), lung (28%) and liver (26%) predominated at initial metastatic diagnosis. Results showed that PCM items assessing fatigue, physical pain and trouble sleeping were sensitive to either general effects of disease progression or to effects associated with specific sites of metastasis. Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores. In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.

Conclusions: Disease progression has a detrimental impact on cancer-related symptoms. Delaying disease progression may have a positive impact on patients' HRQoL.

Show MeSH

Related in: MedlinePlus

Flow Diagram of Study Sample Development.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3142199&req=5

Figure 1: Flow Diagram of Study Sample Development.

Mentions: A total of 387 potentially eligible women with stage IV, HER-2 negative disease and at least one disease progression post mBC diagnosis were identified. Of these, 136 (35.1%) were ineligible due to insufficient PCM data, primarily because the PCM was not uniformly administered at all clinics. Another 15% of patients were excluded because of insufficient medical chart data, 8.3% because they received follow-up care at a non-participating clinic, 3.1% because of inadequate follow-up (i.e., < 180 days) after disease progression and 12.1% for other reasons. The remaining 102 patients were deemed study eligible, and represent the final study sample. Figure 1 depicts sample development graphically.


Retrospective study of the effect of disease progression on patient reported outcomes in HER-2 negative metastatic breast cancer patients.

Walker MS, Hasan M, Yim YM, Yu E, Stepanski EJ, Schwartzberg LS - Health Qual Life Outcomes (2011)

Flow Diagram of Study Sample Development.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3142199&req=5

Figure 1: Flow Diagram of Study Sample Development.
Mentions: A total of 387 potentially eligible women with stage IV, HER-2 negative disease and at least one disease progression post mBC diagnosis were identified. Of these, 136 (35.1%) were ineligible due to insufficient PCM data, primarily because the PCM was not uniformly administered at all clinics. Another 15% of patients were excluded because of insufficient medical chart data, 8.3% because they received follow-up care at a non-participating clinic, 3.1% because of inadequate follow-up (i.e., < 180 days) after disease progression and 12.1% for other reasons. The remaining 102 patients were deemed study eligible, and represent the final study sample. Figure 1 depicts sample development graphically.

Bottom Line: Mean age was 57 years, with 72% of patients Caucasian, and 25% African American.Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores.In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.

View Article: PubMed Central - HTML - PubMed

Affiliation: ACORN Research, LLC, 6555 Quince, Suite 400, Memphis, TN 38119, USA. mwalker@acorncro.com

ABSTRACT

Background: This retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs) that assess symptom burden and health related quality of life (HRQoL) in women with metastatic breast cancer (mBC).

Methods: HER-2 negative mBC patients (n = 102) were enrolled from 7 U.S. community oncology practices. Demographic, disease and treatment characteristics were abstracted from electronic medical records and linked to archived Patient Care Monitor (PCM) assessments. The PCM is a self-report measure of symptom burden and HRQoL administered as part of routine care in participating practices. Linear mixed models were used to examine change in PCM scores over time.

Results: Mean age was 57 years, with 72% of patients Caucasian, and 25% African American. Median time from mBC diagnosis to first disease progression was 8.8 months. Metastasis to bone (60%), lung (28%) and liver (26%) predominated at initial metastatic diagnosis. Results showed that PCM items assessing fatigue, physical pain and trouble sleeping were sensitive to either general effects of disease progression or to effects associated with specific sites of metastasis. Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores. In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.

Conclusions: Disease progression has a detrimental impact on cancer-related symptoms. Delaying disease progression may have a positive impact on patients' HRQoL.

Show MeSH
Related in: MedlinePlus