Lung carcinoma symptoms--an independent predictor of survival and an important mediator of African-American disparity in survival

Cancer
C Martin TammemagiPaul Kvale

Abstract

The extent of disease in patients with lung carcinoma is reflected morphologically by stage and pathophysiologically by sign/symptoms. This study evaluates the associations between symptoms and stage, the independent impact of symptoms on survival, predictors of symptoms, and the extent to which symptoms mediate survival disparities. Data from 1154 patients with lung carcinoma were collected from the authors' tumor registry and by abstraction of medical records. Associations were evaluated by logistic and Cox regression analyses. Symptomatic diagnoses were associated with advanced disease stage (odds ratio [OR], 4.53; 95% confidence interval [95%CI], 3.17-6.48). Hoarseness, hemoptysis, dyspnea, noncardiac chest pain, extrathoracic pain, neurologic symptoms, weight loss, and weakness/fatigue (adverse symptoms) were associated independently with relatively higher/advanced stage and/or reduced survival. Adverse symptoms (> or = 1 vs. 0) predicted reduced survival independently of stage and other prognosticators (hazard ratio [HR], 1.84; 95%CI, 1.52-2.21). Independent predictors of adverse symptoms included gender (OR(male vs. female), 1.50; 95%CI, 1.11-2.01), race/ethnicity (OR(black vs. white), 1.62; 95%CI, 1.18-2.21), and marita...Continue Reading

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Citations

Jun 23, 2009·Palliative & Supportive Care·Margaret Quinn RosenzweigRobert Arnold
Mar 22, 2013·Journal of Psychosocial Oncology·Lara TraegerElyse R Park
Mar 17, 2010·Journal of Pain and Symptom Management·Jaw-Shiun TsaiChing-Yu Chen
Nov 28, 2008·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Sara C ErridgeFinbarr Sheehan
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Mar 26, 2015·Journal of General Internal Medicine·Christina BrzezniakCorey A Carter
Apr 24, 2015·Journal of General Internal Medicine·S A Ibrahim
May 2, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Juan P Wisnivesky, Ethan A Halm
Dec 2, 2019·Journal of Cancer Research and Clinical Oncology·Zongwei ChenHaiquan Chen

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