Abstract 3466: Mental health-related quality of life assessment at diagnosis as a predictor for prognosis of colorectal cancer patients
Authors: Reyes Monica E. , Zhou Yeling , Ye Yuanqing , Wu Xifeng , Hildebrandt Michelle 
Published: July 2016

Abstract
Purpose: Health-related quality of life (HR-QoL) is emerging as an important metric for assessing and predicting outcomes in colorectal cancer (CRC) patients. While most studies focus on QoL in treatment response, few studies have investigated the impact of baseline mental health QoL variables on prognosis of CRC patients. The objective of our study was to explore mental health and vitality QoL measurements and association with prognosis in CRC patients.
Patients and Methods: QoL was assessed in a hospital-based cohort of 2,900 non-Hispanic white CRC patients that completed the SF-12 questionnaire within 1-year of diagnosis. Mental Component Summary (MCS) scores were dichotomized by the normalized scoring-based mean of 50. Hazard ratios were generated using univariate cox regression analysis and survival estimates generated using the Kaplan-Meier method. Sub-domain variables under mental health (“downhearted and blue” and “calm and peaceful”) and vitality (“energy”), were scored and dichotomized before stratifying by patient demographics and statistically evaluated.
Results: We observed that CRC patients with poor mental QoL (MCS&lt;50) had a 1.48-fold increased risk (95%CI:1.31-1.66; P = 5.17×10−14) of a poorer prognosis compared to those with a high MCS score (≥50). This corresponded to a 61.9 month reduction in median survival time in this group (log-rank P = 5.88×10−11). Patients that reported feeling downhearted and blue compared to those that did not, had a 65.7 month reduction in median survival time (log-rank P = 1.13×10−5). Similarly, there was an increased survival time for patients that felt peaceful and calm (MST:113.1 months) compared to those that reported not feeling peaceful and calm (MST:59.4 months; log-rank P = 1.36×10−5). The most striking finding was for the energy variable. Patients that reported having energy
compared to those that did not, were found to have significantly better survival with MSTs of &gt;175 months and 42.3 months, respectively (log-rank P = 2.91×10−27). Several patient characteristics (alcohol use, tobacco use, gender and marital status) were significantly associated with these sub-domain measurements. We found those that reported combined poor mental health and vitality had a dramatic reduction in survival by 102.7 months (log-rank P = 8.39×10−18).
Conclusion: We conclude that baseline mental QoL assessment may identify CRC patients at increased risk of a poor prognosis and merits further investigation of these variables as independent CRC prognostic factors. Interestingly, a potential coping mechanism may underlie the protective effect observed among current users of alcohol, while smoking may serve as a risk factor for poor prognosis in those that reported poor mental QoL. Further studies are warranted to explore the relationship between these MCS sub-domain variables and survival in CRC patients.
Citation Format: Monica E. Reyes, Yeling Zhou, Yuanqing Ye, Xifeng Wu, Michelle Hildebrandt. Mental health-related quality of life assessment at diagnosis as a predictor for prognosis of colorectal cancer patients. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3466.