The impact of baseline Edmonton Symptom Assessment Scale scores on treatment and survival in patients with advanced non-small cell lung cancer
Abstract Background & Objectives Palliative systemic therapy is frequently underutilsed in patients with advanced non-small cell lung cancer, for many reasons. The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC,...
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| Veröffentlicht in: | Clinical lung cancer 2018-01, Vol.19 (1), p.e91-e99 |
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| creator | McGee, Sharon F., BSc, MD, PhD Zhang, Tinghua, MSc Jonker, Hannah Laurie, Scott A., MD Goss, Glen, MD Nicholas, Garth, MD Albaimani, Khalid, MD Wheatley-Price, Paul, MD |
| description | Abstract Background & Objectives Palliative systemic therapy is frequently underutilsed in patients with advanced non-small cell lung cancer, for many reasons. The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC, using the Edmonton Symptom Assessment Scale (ESAS), which is a self-reported questionnaire that quantifies symptom burden by asking patients to rate the severity of 9 common symptoms. Methods With ethics approval, we analysed ESAS scores at initial oncology consultation for 461 patients with advanced NSCLC seen at The Ottawa Hospital Cancer Centre (TOHCC) from 2009 to 2012. Subgroup analysis was performed to determine if treatment strategies or overall survival (OS) were related to the total symptom burden, as defined by the sum of the individual ESAS symptom scores. Results The severity of the ESAS total symptom burden score was positively correlated with ECOG performance status (PS) (R=0.48, p |
| doi_str_mv | 10.1016/j.cllc.2017.05.018 |
| format | Article |
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The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC, using the Edmonton Symptom Assessment Scale (ESAS), which is a self-reported questionnaire that quantifies symptom burden by asking patients to rate the severity of 9 common symptoms. Methods With ethics approval, we analysed ESAS scores at initial oncology consultation for 461 patients with advanced NSCLC seen at The Ottawa Hospital Cancer Centre (TOHCC) from 2009 to 2012. Subgroup analysis was performed to determine if treatment strategies or overall survival (OS) were related to the total symptom burden, as defined by the sum of the individual ESAS symptom scores. Results The severity of the ESAS total symptom burden score was positively correlated with ECOG performance status (PS) (R=0.48, p<0.0001). Furthermore, patients with a higher symptom burden were less likely to receive systemic chemotherapy than those with fewer symptoms (43% versus 66%, p<0.0001), and had a significantly reduced OS (5.5 versus 9.9 months, p<0.0001). A higher ESAS symptom burden score was also associated with reduced OS by univariate analysis (HR1.78, [95% CI 1.45-2.18], p<0.0001), although multivariate analysis showed only a trend towards significance (HR1.27, [95% CI 0.99-1.62], p=0.06). Conclusions Overall, this demonstrates a novel role for the ESAS as a prognostic tool that could complement existing patient assessment models, such as ECOG PS, in the development of optimal treatment plans and estimation of survival, in patients with advanced lung cancer.</description><identifier>ISSN: 1525-7304</identifier><identifier>EISSN: 1938-0690</identifier><identifier>DOI: 10.1016/j.cllc.2017.05.018</identifier><identifier>PMID: 28666762</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung - diagnosis ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - therapy ; Cohort Studies ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Lung Neoplasms - diagnosis ; Lung Neoplasms - mortality ; Lung Neoplasms - therapy ; Male ; Middle Aged ; Neoplasm Staging ; NSCLC ; Overall survival ; Palliative Care ; Patient Reported Outcome Measures ; Performance status ; Prognosis ; Pulmonary/Respiratory ; Research Design ; Surveys and Questionnaires ; Survival Analysis ; Symptom Assessment ; Symptom burden ; Systemic chemotherapy</subject><ispartof>Clinical lung cancer, 2018-01, Vol.19 (1), p.e91-e99</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-cffe30203efc3277a451c5bae7738f1f69322193044faeb5606b81940324462d3</citedby><cites>FETCH-LOGICAL-c411t-cffe30203efc3277a451c5bae7738f1f69322193044faeb5606b81940324462d3</cites><orcidid>0000-0002-3725-9767</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cllc.2017.05.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,46004</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28666762$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McGee, Sharon F., BSc, MD, PhD</creatorcontrib><creatorcontrib>Zhang, Tinghua, MSc</creatorcontrib><creatorcontrib>Jonker, Hannah</creatorcontrib><creatorcontrib>Laurie, Scott A., MD</creatorcontrib><creatorcontrib>Goss, Glen, MD</creatorcontrib><creatorcontrib>Nicholas, Garth, MD</creatorcontrib><creatorcontrib>Albaimani, Khalid, MD</creatorcontrib><creatorcontrib>Wheatley-Price, Paul, MD</creatorcontrib><title>The impact of baseline Edmonton Symptom Assessment Scale scores on treatment and survival in patients with advanced non-small cell lung cancer</title><title>Clinical lung cancer</title><addtitle>Clin Lung Cancer</addtitle><description>Abstract Background & Objectives Palliative systemic therapy is frequently underutilsed in patients with advanced non-small cell lung cancer, for many reasons. The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC, using the Edmonton Symptom Assessment Scale (ESAS), which is a self-reported questionnaire that quantifies symptom burden by asking patients to rate the severity of 9 common symptoms. Methods With ethics approval, we analysed ESAS scores at initial oncology consultation for 461 patients with advanced NSCLC seen at The Ottawa Hospital Cancer Centre (TOHCC) from 2009 to 2012. Subgroup analysis was performed to determine if treatment strategies or overall survival (OS) were related to the total symptom burden, as defined by the sum of the individual ESAS symptom scores. Results The severity of the ESAS total symptom burden score was positively correlated with ECOG performance status (PS) (R=0.48, p<0.0001). Furthermore, patients with a higher symptom burden were less likely to receive systemic chemotherapy than those with fewer symptoms (43% versus 66%, p<0.0001), and had a significantly reduced OS (5.5 versus 9.9 months, p<0.0001). A higher ESAS symptom burden score was also associated with reduced OS by univariate analysis (HR1.78, [95% CI 1.45-2.18], p<0.0001), although multivariate analysis showed only a trend towards significance (HR1.27, [95% CI 0.99-1.62], p=0.06). Conclusions Overall, this demonstrates a novel role for the ESAS as a prognostic tool that could complement existing patient assessment models, such as ECOG PS, in the development of optimal treatment plans and estimation of survival, in patients with advanced lung cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnosis</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>NSCLC</subject><subject>Overall survival</subject><subject>Palliative Care</subject><subject>Patient Reported Outcome Measures</subject><subject>Performance status</subject><subject>Prognosis</subject><subject>Pulmonary/Respiratory</subject><subject>Research Design</subject><subject>Surveys and Questionnaires</subject><subject>Survival Analysis</subject><subject>Symptom Assessment</subject><subject>Symptom burden</subject><subject>Systemic chemotherapy</subject><issn>1525-7304</issn><issn>1938-0690</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UsuO1DAQtBCIXQZ-gAPykUuCH4mTSAhptVoe0kocZjlbjtNhPSR2cDuD5if4Zhxm4cCBS9tyV5XaVU3IS85Kzrh6cyjtNNlSMN6UrC4Zbx-RS97JtmCqY4_zvRZ10UhWXZBniAfGhJJcPCUXolVKNUpckp9390DdvBibaBhpbxAm54HeDHPwKXi6P81LCjO9QgTEGXyie2smoGhDBKQZkiKY9Ltj_EBxjUd3NBN1ni4mufyO9IdL99QMR-MtDNQHX-BspolayGVa_Vdqt1Z8Tp6MZkJ48XDuyJf3N3fXH4vbzx8-XV_dFrbiPBV2HEEywSSMVoqmMVXNbd0baBrZjnxUnRQiO8GqajTQ14qpvuVdxaSoKiUGuSOvz7pLDN9XwKRnh9swxkNYUfOO17JqNo0dEWeojQExwqiX6GYTT5ozveWgD3rLQW85aFbrnEMmvXrQX_sZhr-UP8ZnwNszAPIvjw6iRputyu64CDbpIbj_67_7h25zbC4H8w1OgIewRp_901yj0Ezvt03YFoHnwlVTy1-mHK-4</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>McGee, Sharon F., BSc, MD, PhD</creator><creator>Zhang, Tinghua, MSc</creator><creator>Jonker, Hannah</creator><creator>Laurie, Scott A., MD</creator><creator>Goss, Glen, MD</creator><creator>Nicholas, Garth, MD</creator><creator>Albaimani, Khalid, MD</creator><creator>Wheatley-Price, Paul, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3725-9767</orcidid></search><sort><creationdate>20180101</creationdate><title>The impact of baseline Edmonton Symptom Assessment Scale scores on treatment and survival in patients with advanced non-small cell lung cancer</title><author>McGee, Sharon F., BSc, MD, PhD ; Zhang, Tinghua, MSc ; Jonker, Hannah ; Laurie, Scott A., MD ; Goss, Glen, MD ; Nicholas, Garth, MD ; Albaimani, Khalid, MD ; Wheatley-Price, Paul, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-cffe30203efc3277a451c5bae7738f1f69322193044faeb5606b81940324462d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Non-Small-Cell Lung - diagnosis</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - therapy</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Lung Neoplasms - diagnosis</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>NSCLC</topic><topic>Overall survival</topic><topic>Palliative Care</topic><topic>Patient Reported Outcome Measures</topic><topic>Performance status</topic><topic>Prognosis</topic><topic>Pulmonary/Respiratory</topic><topic>Research Design</topic><topic>Surveys and Questionnaires</topic><topic>Survival Analysis</topic><topic>Symptom Assessment</topic><topic>Symptom burden</topic><topic>Systemic chemotherapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McGee, Sharon F., BSc, MD, PhD</creatorcontrib><creatorcontrib>Zhang, Tinghua, MSc</creatorcontrib><creatorcontrib>Jonker, Hannah</creatorcontrib><creatorcontrib>Laurie, Scott A., MD</creatorcontrib><creatorcontrib>Goss, Glen, MD</creatorcontrib><creatorcontrib>Nicholas, Garth, MD</creatorcontrib><creatorcontrib>Albaimani, Khalid, MD</creatorcontrib><creatorcontrib>Wheatley-Price, Paul, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical lung cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McGee, Sharon F., BSc, MD, PhD</au><au>Zhang, Tinghua, MSc</au><au>Jonker, Hannah</au><au>Laurie, Scott A., MD</au><au>Goss, Glen, MD</au><au>Nicholas, Garth, MD</au><au>Albaimani, Khalid, MD</au><au>Wheatley-Price, Paul, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of baseline Edmonton Symptom Assessment Scale scores on treatment and survival in patients with advanced non-small cell lung cancer</atitle><jtitle>Clinical lung cancer</jtitle><addtitle>Clin Lung Cancer</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>19</volume><issue>1</issue><spage>e91</spage><epage>e99</epage><pages>e91-e99</pages><issn>1525-7304</issn><eissn>1938-0690</eissn><abstract>Abstract Background & Objectives Palliative systemic therapy is frequently underutilsed in patients with advanced non-small cell lung cancer, for many reasons. The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC, using the Edmonton Symptom Assessment Scale (ESAS), which is a self-reported questionnaire that quantifies symptom burden by asking patients to rate the severity of 9 common symptoms. Methods With ethics approval, we analysed ESAS scores at initial oncology consultation for 461 patients with advanced NSCLC seen at The Ottawa Hospital Cancer Centre (TOHCC) from 2009 to 2012. Subgroup analysis was performed to determine if treatment strategies or overall survival (OS) were related to the total symptom burden, as defined by the sum of the individual ESAS symptom scores. Results The severity of the ESAS total symptom burden score was positively correlated with ECOG performance status (PS) (R=0.48, p<0.0001). Furthermore, patients with a higher symptom burden were less likely to receive systemic chemotherapy than those with fewer symptoms (43% versus 66%, p<0.0001), and had a significantly reduced OS (5.5 versus 9.9 months, p<0.0001). A higher ESAS symptom burden score was also associated with reduced OS by univariate analysis (HR1.78, [95% CI 1.45-2.18], p<0.0001), although multivariate analysis showed only a trend towards significance (HR1.27, [95% CI 0.99-1.62], p=0.06). Conclusions Overall, this demonstrates a novel role for the ESAS as a prognostic tool that could complement existing patient assessment models, such as ECOG PS, in the development of optimal treatment plans and estimation of survival, in patients with advanced lung cancer.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28666762</pmid><doi>10.1016/j.cllc.2017.05.018</doi><orcidid>https://orcid.org/0000-0002-3725-9767</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - therapy Cohort Studies Female Hematology, Oncology and Palliative Medicine Humans Lung Neoplasms - diagnosis Lung Neoplasms - mortality Lung Neoplasms - therapy Male Middle Aged Neoplasm Staging NSCLC Overall survival Palliative Care Patient Reported Outcome Measures Performance status Prognosis Pulmonary/Respiratory Research Design Surveys and Questionnaires Survival Analysis Symptom Assessment Symptom burden Systemic chemotherapy |
| title | The impact of baseline Edmonton Symptom Assessment Scale scores on treatment and survival in patients with advanced non-small cell lung cancer |
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