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Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?

BACKGROUND: Advanced pancreatic cancer (APC) patients often have substantial symptom burden. In Ontario, patients routinely complete the Edmonton Symptom Assessment Scale (ESAS), which screens for nine symptoms (scale: 0‐10), in cancer clinics. We explored the association between baseline patient‐re...

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Autores principales: Dai, Wei Fang, Beca, Jaclyn, Guo, Helen, Isaranawatchai, Wanrudee, Schwartz, Deborah, Naipaul, Rohini, Arias, Jessica, Qiao, Yao, Gavura, Scott, Redmond‐Misner, Ruby, Ismail, Zahra, Barbera, Lisa, Chan, Kelvin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943146/
https://www.ncbi.nlm.nih.gov/pubmed/31736256
http://dx.doi.org/10.1002/cam4.2704
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author Dai, Wei Fang
Beca, Jaclyn
Guo, Helen
Isaranawatchai, Wanrudee
Schwartz, Deborah
Naipaul, Rohini
Arias, Jessica
Qiao, Yao
Gavura, Scott
Redmond‐Misner, Ruby
Ismail, Zahra
Barbera, Lisa
Chan, Kelvin
author_facet Dai, Wei Fang
Beca, Jaclyn
Guo, Helen
Isaranawatchai, Wanrudee
Schwartz, Deborah
Naipaul, Rohini
Arias, Jessica
Qiao, Yao
Gavura, Scott
Redmond‐Misner, Ruby
Ismail, Zahra
Barbera, Lisa
Chan, Kelvin
author_sort Dai, Wei Fang
collection PubMed
description BACKGROUND: Advanced pancreatic cancer (APC) patients often have substantial symptom burden. In Ontario, patients routinely complete the Edmonton Symptom Assessment Scale (ESAS), which screens for nine symptoms (scale: 0‐10), in cancer clinics. We explored the association between baseline patient‐reported outcomes, via ESAS, and overall survival (OS). METHODS: Advanced pancreatic cancer patients with ESAS records prior to receiving publicly funded drugs from November 2008 to March 2016 were retrospectively identified from Cancer Care Ontario's administrative databases. We examined three composite ESAS scores: total symptom distress score (TSDS: 9 symptoms), physical symptom score (PHS: 6/9 symptoms), and psychological symptom score (PSS: 2/9 symptoms); Composite scores greater than defined thresholds (TSDS ≥36, PHS ≥24, PSS ≥8) were considered as high symptom burden. Crude OS was assessed using Kaplan‐Meier method. Hazard ratios (HRs) were assessed using multivariable Cox models. Analysis was repeated in a sub‐cohort with Eastern Cooperative Oncology Group (ECOG) status and metastasis. RESULTS: We identified 2199 APC patients (mean age 64 years, 55% male) with ESAS records prior to receiving chemotherapy. Crude median survival was 4.5 and 7.3 months for high and low TSDS, respectively. High TSDS was associated with lower OS (HR = 1.47, 95% CI: 1.33, 1.63). In the sub‐cohort (n = 393) with ECOG status and metastasis, high TSDS was also associated with lower OS (HR = 1.34, 95% CI: 1.04, 1.73). Similar trends were observed for PHS and PSS. CONCLUSIONS: Higher burden of patient‐reported outcome was associated with reduced OS among APC patients. The effect was prominent after adjusting for ECOG status.
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spelling pubmed-69431462020-01-07 Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer? Dai, Wei Fang Beca, Jaclyn Guo, Helen Isaranawatchai, Wanrudee Schwartz, Deborah Naipaul, Rohini Arias, Jessica Qiao, Yao Gavura, Scott Redmond‐Misner, Ruby Ismail, Zahra Barbera, Lisa Chan, Kelvin Cancer Med Clinical Cancer Research BACKGROUND: Advanced pancreatic cancer (APC) patients often have substantial symptom burden. In Ontario, patients routinely complete the Edmonton Symptom Assessment Scale (ESAS), which screens for nine symptoms (scale: 0‐10), in cancer clinics. We explored the association between baseline patient‐reported outcomes, via ESAS, and overall survival (OS). METHODS: Advanced pancreatic cancer patients with ESAS records prior to receiving publicly funded drugs from November 2008 to March 2016 were retrospectively identified from Cancer Care Ontario's administrative databases. We examined three composite ESAS scores: total symptom distress score (TSDS: 9 symptoms), physical symptom score (PHS: 6/9 symptoms), and psychological symptom score (PSS: 2/9 symptoms); Composite scores greater than defined thresholds (TSDS ≥36, PHS ≥24, PSS ≥8) were considered as high symptom burden. Crude OS was assessed using Kaplan‐Meier method. Hazard ratios (HRs) were assessed using multivariable Cox models. Analysis was repeated in a sub‐cohort with Eastern Cooperative Oncology Group (ECOG) status and metastasis. RESULTS: We identified 2199 APC patients (mean age 64 years, 55% male) with ESAS records prior to receiving chemotherapy. Crude median survival was 4.5 and 7.3 months for high and low TSDS, respectively. High TSDS was associated with lower OS (HR = 1.47, 95% CI: 1.33, 1.63). In the sub‐cohort (n = 393) with ECOG status and metastasis, high TSDS was also associated with lower OS (HR = 1.34, 95% CI: 1.04, 1.73). Similar trends were observed for PHS and PSS. CONCLUSIONS: Higher burden of patient‐reported outcome was associated with reduced OS among APC patients. The effect was prominent after adjusting for ECOG status. John Wiley and Sons Inc. 2019-11-17 /pmc/articles/PMC6943146/ /pubmed/31736256 http://dx.doi.org/10.1002/cam4.2704 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Dai, Wei Fang
Beca, Jaclyn
Guo, Helen
Isaranawatchai, Wanrudee
Schwartz, Deborah
Naipaul, Rohini
Arias, Jessica
Qiao, Yao
Gavura, Scott
Redmond‐Misner, Ruby
Ismail, Zahra
Barbera, Lisa
Chan, Kelvin
Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title_full Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title_fullStr Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title_full_unstemmed Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title_short Are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
title_sort are population‐based patient‐reported outcomes associated with overall survival in patients with advanced pancreatic cancer?
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943146/
https://www.ncbi.nlm.nih.gov/pubmed/31736256
http://dx.doi.org/10.1002/cam4.2704
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