Grotmol KS, et al. – Study's goal was to find out whether depression contributed to impairment of quality of life (QoL) irrespective of prognostic factors and symptom burden. It was found that depression severity was the strongest single predictor of poorer QoL in this sample of patients with advanced cancer, after accounting for a wide range of clinically relevant variables. This investigation emphasized the importance of managing depression to achieve the best possible QoL for these patients.

Methods

• Participants were five hundred sixty-three patients from the European Palliative Care Research Collaborative Study (EPCRC-CSA), an international, multi-centre, cross-sectional study.
• The relative importance of prognostic factors (systemic inflammation (mGPS), co-morbidities and physical performance (KPS), symptom burden (loss of appetite, breathlessness, nausea (ESAS) and pain (BPI)) and depression severity (PHQ-9) in predicting Global Health/QoL (EORTC-QLQ-C30) were evaluated utilizing hierarchical multiple regression models.

Results

• The results of this study showed that 55% were females, median age 64 years, 87% had metastatic disease, median KPS was 70 and mean global QoL 50.5 (SD=23.3).
• Findings revealed that worse QoL was related to increased systemic inflammation (mGPS=1 β=-0.12, p=0.003, mGPS=2 β=-0.09, p=0.023), lower physical performance (β=0.17, p<0.001), reduced appetite (β=-0.15, p<0.001), breathlessness (β=-0.11, p=0.004), pain (β=-0.14, p=0.002), and higher depression severity (β=-0.27, p<0.001).
• The present data indicated that the full model accounted for 29% of the observed variance in QoL scores.
• It was noted that the strongest predictor was depression severity, accounting for 5.8% of the variance.