Two-year quality of life after breast cancer surgery: A comparison of three surgical procedures |
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Authors: | H.Y. ShiY.H. Uen L.C. YenR. Culbertson C.H. JuanM.F. Hou |
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Affiliation: | a Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 807 Kaohsiung, Taiwan, ROC b Department of Surgery, Chi Mei Medical Center, 702 Tainan, Taiwan, ROC c Department of Global Health Systems and Development, Tulane University, New Orleans 70112, LA, USA d Department of Nursing, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan, ROC e Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan, ROC f Cancer Center, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan, ROC g National Sun Yat-Sen University-Kaohsiung Medical University Joint Research Center, 804 Kaohsiung, Taiwan, ROC |
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Abstract: | PurposeTo analyze longitudinal changes in each subscale of a quality of life (QOL) measure and to explore their relationships to effective QOL predictors in breast cancer surgery patients.Patients and methodsThis prospective study analyzed 172 patients at two tertiary academic hospitals. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline and at 1 and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation (GEE) before and after surgery.ResultsA 2-year follow-up survey of the examined population revealed significant (P < 0.05) improvement in each QOL subscale. In both postoperative surveys, effect size was largest in the QLQ subscales for patients who had received mastectomy with reconstruction and lowest in those who had received modified radical mastectomy. After adjusting for time effects and baseline predictors, GEE approaches revealed the following explanatory variables for QOL: time, type of surgical procedure, age, chemotherapy, radiotherapy, hormone therapy, and preoperative functional status.ConclusionsWhen evaluating QOL after breast cancer surgery, several factors other than the surgery itself should be considered. Patients should also be advised that their postoperative QOL might depend not only on the success of their operations, but also on their preoperative functional status. |
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Keywords: | Quality of life Breast cancer Generalized estimating equation Bootstrap |
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