Perception of prognosis and health-related quality of life in patients with advanced cancer: results of a multicentre observational study (eQuiPe)

• Published in: Supportive care in cancer Vol. 31; no. 3; p. 165
• Main Authors: Zijlstra, Myrte, van Roij, J., Henselmans, I., van Laarhoven, H. W. M., Creemers, G. J., Vreugdenhil, G., Kuip, E. J. M., van de Poll-Franse, L. V., Raijmakers, N. J. H.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2023; Springer; Springer Nature B.V
• Subjects: Adaptation, Psychological; Cancer; Health psychology; Humans; Medical prognosis; Medicine; Medicine & Public Health; Neoplasms - therapy; Nursing; Nursing Research; Observational studies; Oncology; Oncology, Experimental; Pain Medicine; Palliative Care; Perceptions; Prognosis; Quality of Life; Rehabilitation Medicine; Palliative care; Advanced cancer; Perceived prognosis; Quality of life
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-023-07631-8

Purpose
To assess perception of prognosis in patients with advanced cancer, its association with patient’s characteristics and health-related quality of life (HRQoL).
Methods
In a multicentre observational cohort study (eQuiPe), conducted on patients with advanced cancer, perceived prognosis, coping strategies, and HRQoL were assessed. Clinical data were obtained from the Netherlands Cancer Registry. Patients with vs. without a perception of prognosis, patients who perceived their prognosis as limited (< 1 year) vs. longer (> 1 year), and patients who did not want to know their prognosis vs. those who did not know for other reasons were compared.
Results
Of 1000 patients with advanced cancer, 29% perceived their prognosis as > 1 year, 13% < 1 year, and 4% non-life threatening. Thirty-six percent did not know their prognosis and another 15% did not want to know. Patients without a perception were older, lower educated, coped differently (less accepting, planning, active; more denial), and received treatment more often (
p
 < 0.05). Global QoL was lower in patients with vs. without a perceived prognosis (66 (SD21) vs. 69 (SD19),
p
 = 0.01), specifically in patients who perceived a limited rather than a longer prognosis (57 (SD22) vs. 70 (SD19),
p
 < 0.01). Global QoL of patients who did not want to know their prognosis was comparable to patients who did not know for other reasons (71 (SD19) vs. 69 (SD19),
p
 = 0.22).
Conclusion
More than half of the patients with advanced cancer have no perception of their prognosis. Patients with a perceived prognosis have lower HRQoL, but only in patients who perceived their prognosis as limited (< 1 year) and were probably closer to the end of life, which more likely determines their poorer HRQoL, rather than prognostic perception. Ignorance of prognosis is not associated with lower HRQoL, however, should not hamper appropriate palliative care.