Abstract
Objectives: This study attempts to quantify the difference in loss of quality-adjusted life expectancy (QALE) for patients with operable and inoperable non-small-cell lung cancer (NSCLC). Patients and methods: A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0-1 was monitored for 7 years (2005-2011) to obtain the survival function. This was further extrapolated to lifetime, based on the survival ratios between patients and age- and sex-matched referents simulated from the life tables of the National Vital Statistics of Taiwan. Between 2011 and 2012, EuroQol 5-dimension questionnaires were used to prospectively measure the quality-of-life (QoL) of a 518 consecutive, cross-sectional subsample. We adjusted the lifetime survival function by the utility values of QoL for the cancer cohort to obtain the QALE, while that for the age and sex-matched referents were adjusted to the values collected from the 2009 National Health Interview Survey, and the difference between them was the loss-of-QALE. Results: The QALE for patients with operable and inoperable NSCLC were 11.66 ± 0.18 and 1.43 ± 0.05 quality-adjusted life year (QALY), with the corresponding loss-of-QALE of 5.25 ± 0.18 and 14.24 ± 0.05 QALY, respectively. The lifetime utility difference for patients with operable and inoperable NSCLC was 9.00 ± 0.18 QALY, after adjustment for QoL and lead-time bias. Conclusion: The utility gained from surgical operation for operable lung cancer is substantial, even after adjustment for lead-time bias. Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessments to improve patients' values.
| Original language | English |
|---|---|
| Pages (from-to) | 96-101 |
| Number of pages | 6 |
| Journal | Lung Cancer |
| Volume | 86 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 Oct 1 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Pulmonary and Respiratory Medicine
- Cancer Research
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Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer : Adjusting quality-of-life and lead-time bias for utility of surgery. / Yang, Seu-Chun; Lai, Wu-Wei; Chang, Han-Yu; Su, Wu-Chou; Chen, Helen H.W; Wang, Jung-Der.
In: Lung Cancer, Vol. 86, No. 1, 01.10.2014, p. 96-101.Research output: Contribution to journal › Article
TY - JOUR
T1 - Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer
T2 - Adjusting quality-of-life and lead-time bias for utility of surgery
AU - Yang, Seu-Chun
AU - Lai, Wu-Wei
AU - Chang, Han-Yu
AU - Su, Wu-Chou
AU - Chen, Helen H.W
AU - Wang, Jung-Der
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Objectives: This study attempts to quantify the difference in loss of quality-adjusted life expectancy (QALE) for patients with operable and inoperable non-small-cell lung cancer (NSCLC). Patients and methods: A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0-1 was monitored for 7 years (2005-2011) to obtain the survival function. This was further extrapolated to lifetime, based on the survival ratios between patients and age- and sex-matched referents simulated from the life tables of the National Vital Statistics of Taiwan. Between 2011 and 2012, EuroQol 5-dimension questionnaires were used to prospectively measure the quality-of-life (QoL) of a 518 consecutive, cross-sectional subsample. We adjusted the lifetime survival function by the utility values of QoL for the cancer cohort to obtain the QALE, while that for the age and sex-matched referents were adjusted to the values collected from the 2009 National Health Interview Survey, and the difference between them was the loss-of-QALE. Results: The QALE for patients with operable and inoperable NSCLC were 11.66 ± 0.18 and 1.43 ± 0.05 quality-adjusted life year (QALY), with the corresponding loss-of-QALE of 5.25 ± 0.18 and 14.24 ± 0.05 QALY, respectively. The lifetime utility difference for patients with operable and inoperable NSCLC was 9.00 ± 0.18 QALY, after adjustment for QoL and lead-time bias. Conclusion: The utility gained from surgical operation for operable lung cancer is substantial, even after adjustment for lead-time bias. Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessments to improve patients' values.
AB - Objectives: This study attempts to quantify the difference in loss of quality-adjusted life expectancy (QALE) for patients with operable and inoperable non-small-cell lung cancer (NSCLC). Patients and methods: A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0-1 was monitored for 7 years (2005-2011) to obtain the survival function. This was further extrapolated to lifetime, based on the survival ratios between patients and age- and sex-matched referents simulated from the life tables of the National Vital Statistics of Taiwan. Between 2011 and 2012, EuroQol 5-dimension questionnaires were used to prospectively measure the quality-of-life (QoL) of a 518 consecutive, cross-sectional subsample. We adjusted the lifetime survival function by the utility values of QoL for the cancer cohort to obtain the QALE, while that for the age and sex-matched referents were adjusted to the values collected from the 2009 National Health Interview Survey, and the difference between them was the loss-of-QALE. Results: The QALE for patients with operable and inoperable NSCLC were 11.66 ± 0.18 and 1.43 ± 0.05 quality-adjusted life year (QALY), with the corresponding loss-of-QALE of 5.25 ± 0.18 and 14.24 ± 0.05 QALY, respectively. The lifetime utility difference for patients with operable and inoperable NSCLC was 9.00 ± 0.18 QALY, after adjustment for QoL and lead-time bias. Conclusion: The utility gained from surgical operation for operable lung cancer is substantial, even after adjustment for lead-time bias. Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessments to improve patients' values.
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UR - http://www.scopus.com/inward/citedby.url?scp=84908405123&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2014.08.006
DO - 10.1016/j.lungcan.2014.08.006
M3 - Article
C2 - 25178685
AN - SCOPUS:84908405123
VL - 86
SP - 96
EP - 101
JO - Lung Cancer
JF - Lung Cancer
SN - 0169-5002
IS - 1
ER -