Quality of life of survivors of malignant pleural mesothelioma in Japan: a cross sectional study

Our plain-English summary of Quality of life of survivors of malignant pleural mesothelioma in Japan: a cross sectional study, by Y. Nagamatsu, I. Oze, K. Aoe, et al (BMC Cancer, 2018).

The study

• Authors: Y. Nagamatsu, I. Oze, K. Aoe, K. Hotta, K. Kato, J. Nakagawa, K. Hara, T. Kishimoto, N. Fujimoto
• Journal: BMC Cancer
• Published: 2018;18(1):350
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Previous studies have indicated that people with malignant pleural mesothelioma (MPM) have a poor quality of life (QOL); however, information about the QOL of people with MPM in Japan is anecdotal. The aims of this study were to investigate the QOL of survivors of MPM in Japan and to determine the factors that correlate with their QOL.

Methods: This was a cross sectional study. The included patients were those diagnosed with MPM in Japan. We created a self-administered questionnaire consisting of 64 questions. The questionnaires were sent to hospitals and patient advocacy groups, distributed to the patients, completed, and sent back to the researchers by postal mail. QOL was assessed with the European Organization for Research and Treatment of Cancer 16 questionnaire (QLQ) and the short version of the core domains of the Comprehensive Quality of Life Outcome questionnaire (CoQoLo).

Results: In total, 133 questionnaires were collected. The QLQ assessments demonstrated that the survivors of MPM most frequently complained of fatigue, pain, sleep disturbances, and dyspnea. The symptom scales were acceptable, but the functional scales were significantly poorer for the patients with poor performance statuses (PSs). The short CoQoLo assessment was very unfavorable for 'Being free from physical pain.' Being a long-term survivor and a survivor with a poor PS were significantly correlated with poor global health status.

Conclusions: Survivors of MPM have impaired function, a variety of symptoms, and lower QOL. Survivors of MPM, even those in good physical condition, need broad support.

In plain English

This cross-sectional study surveyed people in Japan with malignant pleural mesothelioma (MPM) about quality of life. Questionnaires were handed out through hospitals and a patient advocacy group, and 133 were returned. Of the respondents, 83.5% were men, and their mean age was 69.3 years. The mean global quality-of-life score was 47.9. Fatigue (50.8) and dyspnea, or breathlessness (50.1), had the highest mean symptom scores. On a second questionnaire, scored from 1 to 7, 'Being free from physical pain' scored lowest (3.8). Adjusted for other factors, respondents two or more years past diagnosis had global health status scores 10.36 points lower than those under two years (95% confidence interval 2.19 to 18.53 lower). Poorer performance status, a measure of physical condition, was also linked to lower scores. Women's global health status scores were 10.89 points higher than men's (95% confidence interval 1.30 to 20.48). The authors concluded that MPM survivors have impaired function, a variety of symptoms and lower quality of life, and that even those in good physical condition need broad support. They noted that their sample was small and may have missed the sickest patients.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional study using a self-administered questionnaire of 64 questions, distributed through hospitals and patient advocacy groups and returned by post
• Who was studied: 133 people diagnosed with malignant pleural mesothelioma in Japan who returned questionnaires in 2016: 88 distributed through hospitals (returned by the end of April 2016) and 45 of 94 mailed through a patient advocacy group in March 2016
• Exposure: The study did not measure asbestos exposure or fiber type. It examined quality-of-life scores in relation to clinical and social factors: age, sex, years since diagnosis, surgery, chemotherapy, radiotherapy, palliative care, receipt of compensation, patient advocacy group membership and performance status.
• Main results:
  • Respondents: 83.5% were male; mean age 69.3 years
  • Mean global QOL score on the EORTC QLQ-C30 among all respondents was 47.9
  • Mean symptom scores among all respondents: fatigue 50.8, pain 34.7, nausea and vomiting 12.9, dyspnea 50.1, appetite loss 38.3, sleep disturbance 36.1, constipation 38.1, diarrhea 14.8
  • Symptom and functional scale scores were significantly worse among respondents with poor performance status
  • On the short CoQoLo (7-point scale), the lowest mean item score was 'Being free from physical pain' (3.8) and the highest was 'Trusting physician' (5.8)
  • In the multiple regression analysis, women's QLQ global health status score was 10.89 points higher than men's (95% CI 1.30 to 20.48; p = 0.026). The corresponding difference on the short CoQoLo total, 4.03 (95% CI -0.28 to 8.34; p = 0.067), was not statistically significant.
  • Being two or more years from diagnosis (compared with less than 2 years) and poor performance status were significantly correlated with poorer global health status in the regression analysis. For two or more years, the coefficient was -10.36 (95% CI -18.53 to -2.19; p = 0.011). For performance status 4 compared with 0, it was -73.01.
  • The short CoQoLo total score was also significantly lower among long-term survivors and those with poor performance status. For two or more years from diagnosis, the coefficient was -4.73 (95% CI -8.40 to -1.06; p = 0.012).
• The authors' conclusion: The authors concluded that survivors of MPM have impaired function, a variety of symptoms and lower QOL, and that even those in good physical condition need broad support
• Limitations the authors state:
  • Small convenience sample
  • Data from patients in the terminal stage and those in poor general condition may have been missed
  • Participants' QOL might be better than that of MPM patients generally
  • Cross-sectional study of prevalent cases; a longitudinal study of incident cases is needed

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Quality of Life, Pleural Mesothelioma, Dyspnea, Performance Status.

Related studies

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• Bereaved Family Members' Perspectives of Good Death and Quality of End-of-Life Care for Malignant Pleural Mesothelioma Patients: A Cross-Sectional Study — Y. Nagamatsu, Y. Sakyo, et al. (2022)
• The impact of individual quality of life assessment on psychosocial attention in patients with chest malignancies: a randomized study — M. Nicklasson, M.L. Elfström, et al. (2013)
• A multicentre non-blinded randomised controlled trial to assess the impact of regular early specialist symptom control treatment on quality of life in malignant mesothelioma (RESPECT-MESO): study protocol for a randomised controlled trial — S. Gunatilake, F.J. Brims, et al. (2014)
• Quality of life of patients with end-stage peritoneal metastasis treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) — K. Odendahl, W. Solass, et al. (2015)
• Body composition and nutritional status in malignant pleural mesothelioma: implications for activity levels and quality of life — E. Jeffery, Y.C.G. Lee, et al. (2019)

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