Introduction
Materials and methods
Study design
Outcome measures
Sociodemographic and clinical information
Patient reported outcomes measures
Statistical analysis
Results
Sample characteristics
Total sample N = 298 | Good HRQOL class N = 183 | Poor HRQOL class N = 115 | Effect sizea | Sig. | ||||
---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | |||
Age, mean (SD) | 48.41 (12.97) | 46.27 (12.58) | 51.82 (12.90) | 0.21+++ (0.10–0.31) | < 0.001* | |||
Median; Range | 48; 21–85 | 44; 21–77 | 52; 24–85 | |||||
Months from diagnosis, mean (SD) | 144.18 (70.44) | 138.30 (57.09) | 153.56 (87.05) | 0.11+++ (− 0.01–0.22) | 0.097 | |||
Median; Range | 128; 60–456 | 132; 61–424 | 127; 60–456 | |||||
Sex | ||||||||
Female | 137 | 46 | 85 | 46 | 52 | 45 | 0.01+ (− 0.10–0.13) | 0.836 |
Male | 161 | 54 | 98 | 54 | 63 | 55 | ||
Race | ||||||||
White | 244 | 82 | 148 | 81 | 96 | 83 | − 0.01+ (− 0.13–0.11) | 0.861 |
Otherb | 37 | 13 | 23 | 13 | 14 | 12 | ||
Ethnicityc | ||||||||
Non-Hispanic or Latino | 268 | 90 | 162 | 89 | 106 | 92 | − 0.08+ (− 0.19–0.04) | 0.211 |
Hispanic or Latino | 17 | 6 | 13 | 7 | 4 | 3 | ||
Employment | ||||||||
Employed | 168 | 56 | 125 | 68 | 43 | 37 | 0.30+ (0.19–0.40) | < 0.001* |
Unemployed | 122 | 41 | 55 | 30 | 67 | 58 | ||
Education | ||||||||
≤ High School | 31 | 10 | 22 | 12 | 9 | 8 | 0.06++ (− 0.06–0.17) | 0.540 |
Some college or technical degree | 150 | 50 | 93 | 51 | 57 | 50 | ||
≥ Advanced degree | 105 | 35 | 63 | 34 | 42 | 37 | ||
Income | ||||||||
< $50,000 | 34 | 11 | 18 | 10 | 16 | 14 | 0.01++ (− 0.17–0.19) | 0.664 |
$50,000–$149,999 | 62 | 21 | 37 | 20 | 25 | 22 | ||
≥ $150,000 | 24 | 8 | 12 | 7 | 12 | 10 | ||
Location | ||||||||
Brain | 267 | 90 | 172 | 94 | 95 | 83 | 0.18+ (0.07–0.29) | 0.002* |
Spine | 31 | 10 | 11 | 6 | 20 | 17 | ||
Tumor grade | ||||||||
Low grade (I/II) | 106 | 36 | 70 | 38 | 36 | 31 | 0.03++ (− 0.08–0.14) | 0.138 |
High grade (III/IV) | 178 | 60 | 102 | 56 | 76 | 66 | ||
Other | 14 | 4 | 11 | 6 | 3 | 3 | ||
Tumor classifications | ||||||||
Glioblastoma | 45 | 15 | 29 | 16 | 16 | 14 | ||
Oligodendro-glial tumors | 59 | 20 | 37 | 21 | 22 | 20 | ||
Ependymoma | 48 | 16 | 21 | 11 | 27 | 23 | ||
Active treatment | ||||||||
No | 248 | 83 | 163 | 89 | 85 | 74 | 0.20+ (0.09–0.30) | < 0.001* |
Yes | 50 | 17 | 20 | 11 | 30 | 26 | ||
Received radiation | ||||||||
No | 51 | 17 | 38 | 21 | 13 | 11 | 0.12+ (0.01–0.23) | 0.035 |
Yes | 247 | 83 | 145 | 79 | 102 | 89 | ||
Prior recurrence | ||||||||
No | 90 | 30 | 74 | 40 | 16 | 14 | 0.28+ (0.17–0.38) | < 0.001* |
Yes | 208 | 70 | 109 | 60 | 99 | 86 | ||
KPS | ||||||||
≥ 90 | 157 | 52 | 135 | 74 | 22 | 19 | 0.61+ (0.53–0.68) | < 0.001* |
≤ 80 | 111 | 37 | 28 | 15 | 83 | 72 |
Latent classes for long-term survivor health-related quality of life
Model | LL | AIC | BIC | Entropy | VLMR |
---|---|---|---|---|---|
1 Class | − 1177.52 | 2375.03 | 2412.00 | n/a | n/a |
2 Classa | − 981.78 | 2005.57 | 2083.21 | 0.90 | 391.47† |
3 Class | − 958.75 | 1981.49 | 2099.80 | 0.94 | 46.08* |
Health related quality of life dimensions
Overall sample N = 298 | Good HRQOL class N = 183 | Poor HRQOL class N = 115 | Effect sizea | Sig. | ||||
---|---|---|---|---|---|---|---|---|
N | % | n | % | n | % | |||
Mobility | ||||||||
No problems walking about | 173 | 58 | 167 | 91 | 6 | 5 | 0.85 (0.81–0.88) | < 0.001* |
Some or extreme problems walking about | 125 | 42 | 16 | 9 | 109 | 95 | ||
Self-care | ||||||||
No problems with self-care | 232 | 78 | 183 | 100 | 49 | 43 | 0.67 (0.61–0.73) | < 0.001* |
Some or extreme problems washing or dressing myself | 66 | 22 | 0 | 0 | 66 | 57 | ||
Usual activities | ||||||||
No problems with usual activities | 159 | 53 | 158 | 86 | 1 | 0 | 0.83 (0.80–0.87) | < 0.001* |
Some or extreme problems with usual activities | 139 | 47 | 25 | 14 | 114 | 100 | ||
Pain/discomfort | ||||||||
No pain or discomfort | 184 | 62 | 145 | 79 | 39 | 34 | 0.45 (0.36–0.54) | < 0.001* |
Moderate or extreme pain or discomfort | 114 | 38 | 38 | 21 | 76 | 66 | ||
Anxiety/depression | ||||||||
Not anxious or depressed | 151 | 51 | 113 | 62 | 38 | 33 | 0.28 (0.17–0.38) | < 0.001* |
Moderately or extremely anxious or depressed | 147 | 49 | 70 | 38 | 77 | 67 |
Association of health-related quality of life class with self-reported symptom burden, interference, and mood
Good HRQOL class N = 183 | Poor HRQOL classN = 115 | Effect sizea | Sig. | |||||
---|---|---|---|---|---|---|---|---|
n | Mean | SD | N | Mean | SD | |||
MDASI-BT | ||||||||
Overall symptom burden | 170 | 1.3 | 1.5 | 95 | 2.8 | 1.7 | -0.93 (− 1.20–-0.67) | < 0.001* |
Affective symptom factor | 170 | 2.0 | 2.2 | 95 | 3.8 | 2.6 | -0.79 (− 1.05–-0.53) | < 0.001* |
Cognitive symptom factor | 170 | 1.7 | 2.2 | 95 | 3.4 | 2.7 | -0.70 (− 0.96–-0.44) | < 0.001* |
Neurologic symptom factor | 170 | 0.9 | 1.6 | 95 | 2.6 | 2.0 | -0.94 (− 1.21–00.68) | < 0.001* |
Treatment related symptom factor | 170 | 1.2 | 1.7 | 95 | 2.6 | 2.0 | -0.78 (− 1.03–0.52) | < 0.001* |
General disease symptom factor | 170 | 0.8 | 1.3 | 95 | 2.0 | 1.9 | -0.77 (− 1.03–-0.51) | < 0.001* |
GI symptom factor | 170 | 0.5 | 1.2 | 95 | 0.9 | 1.7 | -0.33 (− 0.59–-0.08) | 0.018* |
Overall interference | 170 | 1.3 | 1.8 | 95 | 4.6 | 2.6 | -1.56 (− 1.84–-1.27) | < 0.001* |
Activity related interference | 170 | 1.3 | 1.9 | 95 | 5.1 | 2.8 | -1.69 (− 1.98–-1.40) | < 0.001* |
Mood related interference | 170 | 1.3 | 1.9 | 95 | 4.1 | 2.9 | -1.22 (− 1.49–-0.95) | < 0.001* |
MDASI-SP | ||||||||
Overall symptom burden | 10 | 1.2 | 1.4 | 19 | 3.1 | 1.9 | -1.08 (− 1.89–-0.25) | 0.01* |
Disease related symptom factor | 10 | 1.4 | 1.9 | 19 | 4.7 | 2.3 | -1.51 (− 2.36–-0.63) | < 0.001* |
Autonomic function symptom factor | 10 | 0.8 | 1.1 | 19 | 2.7 | 3.0 | -0.74 (− 1.52–0.06) | 0.023 |
Constitutional/treatment symptom factor | 10 | 0.9 | 1.4 | 19 | 1.4 | 1.6 | -0.29 (− 1.05–0.48) | 0.467 |
Emotional symptom factor | 10 | 1.8 | 2.2 | 19 | 3.1 | 3.3 | -0.45 (− 1.22–0.33) | 0.260 |
Overall interference | 10 | 1.2 | 2.3 | 19 | 5.1 | 2.7 | -1.54 (− 2.40–-0.66) | 0.001* |
Activity related interference | 10 | 1.3 | 2.4 | 19 | 5.7 | 2.6 | -1.76 (− 2.64–-0.85) | < 0.001* |
Mood related interference | 10 | 1.1 | 2.3 | 19 | 4.5 | 3.0 | -1.23 (− 2.06–-0.39) | 0.004* |
PROMIS-depression | ||||||||
T-score | 183 | 47.3 | 8.8 | 115 | 55.1 | 9.6 | -0.86 (− 1.11–-0.62) | < 0.001* |
Depressive severityb | ||||||||
Moderate-severe (n, %) | 18 | 10 | 33 | 29 | ||||
PROMIS-anxiety | ||||||||
T-score | 183 | 48.9 | 9.6 | 115 | 53.9 | 10.0 | -0.51 (− 0.75–-0.28) | < 0.001* |
Anxiety severityb | ||||||||
Moderate-severe (n, %) | 23 | 13 | 25 | 22 |