scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

2005 ◽  
Vol 92 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Andrea A. Thornton ◽  
Lisa Madlensky ◽  
Shirley W. Flatt ◽  
Robert M. Kaplan ◽  
John P. Pierce ◽  
...  

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Marie Uecker ◽  
Benno Ure ◽  
Julia Hannah Quitmann ◽  
Jens Dingemann

Abstract Survival rates of patients with visceral congenital malformations have increased considerably. However, long-term morbidity in these patients is high. In the last decades, these circumstances have led to a shift in goals of caretakers and researchers with a new focus on patients’ perspectives and long-term morbidity. Health-related quality of life (HrQoL) is the most commonly used patient-reported outcome measure to assess the impact of chronic symptoms on patients’ everyday lives. Most pediatric surgical conditions can cause a significantly decreased HrQoL in affected patients compared to the healthy population. In order to guarantee life-long care and to minimize the impact on HrQoL a regular interdisciplinary follow-up is obligatory. The period of transition from child-centered to adult-oriented medicine represents a critical phase in the long-term care of these complex patients. This scoping review aims to summarize relevant pediatric surgical conditions focusing on long-term-morbidity and HrQoL assessment in order to demonstrate the necessity for a well-structured and standardized transition for pediatric surgical patients.


2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 70-70
Author(s):  
Deepa Lalla ◽  
Amye Tevaarwerk ◽  
Hans-Peter Goertz ◽  
Mary Lou Smith ◽  
Preeti S. Bajaj ◽  
...  

70 Background: Metastatic breast cancer (MBC) and its treatments can have a significant impact on patients’ health-related quality of life (HRQoL) and daily functioning. To better assess the impact of MBC on HRQoL, we conducted an online survey among women with MBC. Methods: We developed and administered a cross-sectional, web-based survey, and invited registered members of three advocacy groups currently living with MBC to participate. Respondents completed an informed consent and completed assessments on symptom burden using an overall QOL question (1 item), the MD Anderson Symptom Inventory Survey (MDASI), activities of daily living (ADLs, Rotterdam Scale), and impacts on work productivity. Results: We received 1285 complete responses to the survey. Over half the respondents were between 40-49yrs (37%) or 30-39 yrs (26%). The majority were white (87.7%), well-educated (70.7% had a bachelor’s degree or higher), and working at the time of the survey (55%), with private health insurance (63%). After diagnosis with MBC, most patients had received endocrine therapy (44.2% aromatase inhibitors, 27.3% fulvestrant). The most common chemotherapy agents received after diagnosis with MBC were capecitabine (30.1%) and docetaxel (26.9%). The overall mean HRQoL score was 74 (0-100, higher is better). Mean respondent-reported MDASI scores for symptom severity (SS) and symptom interference (SI) were 4.2 and 4.5 (0-10, higher is worse). Mean Rotterdam scale scores to assess ADLs were 23.7 (0-32, higher better). On average, working women with MBC missed 9.3 hours of work in the past 7 days due to their MBC. As symptom burden increased, respondents reported a lower ability to perform ADLs (p < 0.0001) and lower overall HRQoL (p < 0.0001). The ability to perform ADLs decreased with increase in the total number of agents received (p < 0.0001) and time since diagnosis (p < 0.0001). Conclusions: This survey provides valuable insights into health status, ability to perform ADLs, and lost productivity among patients with MBC. Future analyses will present results by tumor subtypes and drug treatments received.


Rheumatology ◽  
2021 ◽  
Author(s):  
Ting Zhao ◽  
Tania Winzenberg ◽  
Dawn Aitken ◽  
Barbara de Graaff ◽  
Hasnat Ahmad ◽  
...  

Abstract Objective To investigate the impact of total number and patterns of comorbidities on health-related quality of life (HRQoL) and identify the most prevalent and influential comorbidity patterns in people with osteoarthritis (OA) over ten years. Methods Participants from the Tasmanian Older Adult Cohort aged 50-80 years, with self-reported OA and data on comorbidities and HRQoL were included. Participants were interviewed at baseline (n = 398), 2.5-years (n = 304), 5-years (n = 269) and 10-years (n = 191). Data on the self-reported presence of 10 chronic comorbidities were collected at baseline. HRQoL was assessed using the Assessment of Quality of Life-4-Dimensions. The long-term impacts of the number and of the nine most prevalent combinations of cardiovascular (CVD), non-OA musculoskeletal (Ms), metabolic, and respiratory comorbidities on HRQoL over ten years were analysed using linear mixed regressions. Results Compared with comorbidity-free OA participants, the health state utility (HSU) of those with 2 or ≥ 3 comorbidities was respectively -0.07 and -0.13 units lower over ten years, largely driven by reduced scores for independent living, social relationships and psychological wellness. Comorbidity patterns including ‘CVD+Ms’ were most influential, and associated with up to 0.13 units lower HSU, mostly through negative impacts on independent living (up to -0.12), psychological wellness (up to -0.08) and social relationship (up to -0.06). Conclusion Having more comorbidities negatively impacted OA patients’ long-term HRQoL. OA patients with CVD and non-OA musculoskeletal conditions had the largest HSU impairment, therefore optimal management and prevention of these conditions may yield improvements in OA patients’ HRQoL.


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