Co-morbidity and functional deficits independently contribute to quality of life before chemotherapy in elderly cancer patients

Goal of the work The quality of life (QoL) of patients with cancer is a major area of concern for both patients and their physicians. The independent contribution of functional impairment and co-morbidity to QoL is unclear. Materials and methods We investigated initial global QoL in 477 patients: 195 cancer patients aged 60 years or older (group A), 152 cancer patients below the age of 60 years (group B), admitted as inpatients for chemotherapy initiation and 130 patients aged 60 years or older admitted for non-cancer-related disorders (group C). Global QoL was assessed by the EORTC-QLQ-C30 subscale, functional status by the Karnofsky Performance Scale (KPS) and the Instrumental Activities of Daily Living (IADL) scale, and co-morbidity by the Cumulative Illness Rating Scale (CIRS). Results In multivariate analyses, global QoL is significantly associated with KPS, IADL and co-morbidity in group A (r(2)=0.27), with KPS and IADL in group B (r(2)=0.23), and with age, KPS and IADL in group C (r(2)=0.38). Conclusions IADL contributes to global QoL in addition to the known effect of KPS. In addition, co-morbidity independently influences global QoL in elderly cancer patients.