Determinants of health-related quality of life in elderly ovarian cancer patients: The role of frailty and dependence

Fernanda Nunes de Arruda; Maaike H M Oonk; Marian J E Mourits; Pauline de Graeff; Mathilde Jalving; Geertruida H de Bock

doi:10.1016/j.ygyno.2019.03.249

Determinants of health-related quality of life in elderly ovarian cancer patients: The role of frailty and dependence

Gynecol Oncol. 2019 Jun;153(3):610-615. doi: 10.1016/j.ygyno.2019.03.249. Epub 2019 Mar 29.

Authors

Fernanda Nunes de Arruda¹, Maaike H M Oonk², Marian J E Mourits², Pauline de Graeff³, Mathilde Jalving⁴, Geertruida H de Bock⁵

Affiliations

¹ Department of Epidemiology, University of Groningen, University Medical Center Groningen (UMCG), the Netherlands; Faculty of Medicine of University of São Paulo (FMUSP), Brazil.
² Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen (UMCG), the Netherlands.
³ Department of Internal Medicine, University Center of Geriatric Medicine, University of Groningen, University Medical Center Groningen, the Netherlands.
⁴ Department of Medical Oncology, University of Groningen, University Medical Center Groningen (UMCG), the Netherlands.
⁵ Department of Epidemiology, University of Groningen, University Medical Center Groningen (UMCG), the Netherlands. Electronic address: g.h.de.bock@umcg.nl.

PMID: 30935716
DOI: 10.1016/j.ygyno.2019.03.249

Abstract

Objective: To investigate the impact of frailty and dependence on health-related quality of life (HRQOL) in elderly women diagnosed with epithelial ovarian cancer (EOC).

Methods: Data was gathered from a prospectively collected data biobank, OncoLifeS (Oncological Life Study) at the University Medical Center of Groningen. Women with a diagnosis of EOC, ≥65 years of age, with baseline assessment available from January 2016 to May 2018 were included. HRQOL was determined using the EORTC QLQ-C30 yielding scores on Global Health Status, five functional scales, three symptom scales, and six single items. The summary score was also calculated. Frailty was measured using the Groningen Frailty Indicator (GFI), and dependence using the Instrumental Activities of Daily Living (IADL). To evaluate the impact of frailty and dependence on HRQOL, linear regression was performed. Analyses were adjusted for age and tumor stage.

Results: 84 patients were included. Median age was 71 years (IQR: 68-75), 78% had advanced stage and 81% serous histology. Overall, the median global health status was 67 (IQR: 50-83). HRQOL scales with lowest scores were: role functioning (median: 66.7; IQR: 33-100), fatigue (median: 33.3; IQR: 22-56) and insomnia (median: 33.3; IQR: 0-67). Being frail was associated with worse functioning on all HRQOL scales and higher symptom scores (p = .001). Conversely, being independent was associated with better functioning on all HRQOL scales and lower symptom scores. These associations remained significant after adjusting for age and tumor stage.

Conclusion: In women ≥65 years, diagnosed with EOC, frailty and dependence are associated to reduced HRQOL. These associations remain significant adjusting for age and stage.

Keywords: Elderly; Frailty; Ovarian neoplasms; Quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Carcinoma, Ovarian Epithelial / complications*
Fatigue / etiology
Female
Frailty / complications*
Health Status
Humans
Ovarian Neoplasms / complications*
Quality of Life*
Sleep Initiation and Maintenance Disorders / etiology