Prognostic value of health-related quality-of-life parameters in early-stage breast cancer: an 8-year follow-up study

Objective: The purpose was to investigate whether self-reported health-related quality-of-life (HRQOL) parameters at time of diagnosis and/or 1-year follow-up are prognostic for disease-free survival (DFS) in early-stage breast cancer patients. Methods: Data from 195 women, diagnosed with early-stage breast cancer, who had filled in the EORTC QLQ-C30 and the Hospital Anxiety and Depression Scale (HADS) at time of diagnosis and 1 year after surgery, were analyzed. Results: After a median follow-up of 8.2 years (range 0.09-9.45), 27 (14.1%) deaths and 22 (11.5%) recurrences were observed. Using Cox multivariate regression analysis, appetite loss reported 1-year following surgery (HR 2.92, 95% CI 1.50-5.66), p = 0.002) was significantly predictive for shorter DFS, even after controlling for age and depression. None of the clinical or biological prognostic factors was found to have a confounding effect. Conclusion: The findings indicate that loss of appetite probably is of prognostic value in addition to well-recognized clinical and biological data, in early-stage breast cancer. Copyright (C) 2010 John Wiley & Sons, Ltd.