Quality of life and survival: The role of multidimensional symptom assessment Journal Article


Authors: Chang, V. T.; Thaler, H. T.; Polyak, T. A.; Kornblith, A. B.; Lepore, J. M.; Portenoy, R. K.
Article Title: Quality of life and survival: The role of multidimensional symptom assessment
Abstract: BACKGROUND. Recent data from clinical trials suggest that quality-of- life (QOL) measurements may independently predict survival. The relation between survival and QOL measurements was tested among 122 inpatients and 96 outpatients with malignancies at one of four sites (colon, breast, ovary, or prostate) who participated in a cross-sectional validation study of the Memorial Symptom Assessment Scale (MSAS), a measure of the frequency of, severity of, and distress caused by physical symptoms. METHODS. The relation between MSAS summary scores and survival was evaluated in a multivariate analysis that adjusted concurrently for other important covariates, such as age, site and extent of disease, inpatient status, Karnofsky performance status (KPS), and other QOL measurements. RESULTS. In the multivariate analysis, extent of disease (P < 0.0001), inpatient status (P = 0.014), higher MSAS physical symptom subscale score (P = 0.004), and lower KPS score [P = 0.009) independently predicted decreased survival. Other QOL measurements did not contribute significantly to the model. CONCLUSIONS. The MSAS physical symptom subscale score significantly predicts survival and adds to the prognostic information provided by KPS and extent of disease. Patients may be under-assessed regarding both the number and the severity of symptoms. Measurements of physical symptoms and related distress offer additional prognostic information concerning the survival of patients with cancer and may account for the predictive value of QOL scores.
Keywords: survival; adult; cancer survival; aged; aged, 80 and over; middle aged; survival rate; major clinical study; neoplasm; neoplasms; quality of life; ovary cancer; breast cancer; prostate cancer; colon cancer; scoring system; malignant neoplastic disease; multivariate analysis; symptomatology; distress; symptoms; humans; human; male; female; priority journal; article
Journal Title: Cancer
Volume: 83
Issue: 1
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1998-07-01
Start Page: 173
End Page: 179
Language: English
DOI: 10.1002/(sici)1097-0142(19980701)83:1<173::aid-cncr23>3.0.co;2-t
PUBMED: 9655308
PROVIDER: scopus
DOI/URL:
Notes: Article -- Presented in part at the 31st Annual Scientific Meeting of the American Society of Clinical Oncology that took place May 20 –23, 1995 in Los Angeles, CA -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. Tatyana A Polyak
    10 Polyak
  2. Howard T Thaler
    245 Thaler
  3. Russell K. Portenoy
    165 Portenoy