Prevalence, intensity, and prognostic significance of common symptoms in terminally ill cancer patients

J Palliat Med. 2013 Jul;16(7):752-7. doi: 10.1089/jpm.2013.0028. Epub 2013 May 22.

Abstract

Background: Quality of life and palliative management of end-stage cancer patients should improve with greater understanding of the prevalence, intensity, and prognostic significance of their symptoms.

Objective: We investigated the association between prevalence and intensity of common symptoms and overall survival in Chinese end-stage cancer patients.

Design: For this cross-sectional study, 163 Chinese patients with end-stage cancer completed an Edmonton Symptom Assessment questionnaire, and each was given a Karnofsky Performance Status (KPS) score. Overall survival was estimated via the Kaplan-Meier method. Factors affecting overall survival were determined by univariate and multivariate Cox regression analyses.

Results: Mean survival of these patients was 51 days. Pain, lack of appetite, and poor well-being were the most frequent symptoms, in 90.2%, 88.3%, and 87.7%, respectively. The most severe symptoms were fatigue, lack of appetite, drowsiness, and poor well-being. Fatigue, lack of appetite, drowsiness, shortness of breath, poor well-being, depression, and KPS score significantly affected overall survival rate, with a relative risk of dying of 1.560, 2.320, 1.684, 1.295, 1.912, 1.414, and 0.487, respectively (Cox regression coefficients: 0.361, 0.827, 0.539, 0.185, 0.694, 0.318, and -0.602). Fatigue, lack of appetite, shortness of breath, age, and KPS score were independent risk factors of overall survival, with a relative risk of dying of 1.581, 1.122, 1.123, 1.022, and 0.797, respectively (Cox regression coefficients: 0.458, 0.115, 0.116, 0.022, and -0.227).

Conclusion: Fatigue, shortness of breath, lack of appetite, age, and KPS score were associated with overall survival of end-stage Chinese cancer patients.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • China
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasms / classification
  • Neoplasms / pathology
  • Neoplasms / physiopathology*
  • Palliative Care / organization & administration
  • Palliative Care / standards*
  • Prognosis
  • Proportional Hazards Models
  • Quality of Life*
  • Regression Analysis
  • Severity of Illness Index
  • Terminally Ill*
  • Young Adult