Title: Evaluation of quality of life in survivors with malignant pleural mesothelioma in Japan
Abstract: Background: Malignant pleural mesothelioma (MPM) is the malignancy with poor prognosis. Most patients with MPM present severe symptoms such as pain, dyspnea and fatigue. Because of the symptoms and poor prognosis, MPM survivors would have poor Quality of Life (QOL), however, their QOL has not been well evaluated. Methods: Subjects were the survivors of MPM. We asked the cancer hospitals in Japan and MPM Patients' Association to distribute the self-administered questionnaire. QOL was evaluated using scales of the EORTC QLQ-C30 and QoQoLo short version. In addition to the QOL, clinical factors were collected using the questionnaire. Mean and its standard deviation were used to evaluate QOL scores. Wilcoxon rank sum test was used to compare the QOL scores. Factors affecting the QOL score were evaluated by multiple regression model. Results: In total, 133 survivors with MPM participated in the study. Regarding the QOL evaluated by QLQ-C30: functional scales were poor (scores >50), while symptom scales were not so poor (scores <50). When stratified by performance status (PS), functional scores were worse in survivors with good PS than those with poor PS, while symptom scales were better in good PS survivors than those with poor PS. CoQoLo scale showed MPM survivors had good relationships with their doctors, whereas, they suffered from physical and psychological pain, and had the feeling to be a burden to others. Global health status score evaluated by QLQ-C30 were significantly better among survivors with good PS, >2 years from diagnosis, and female. Similarly, good PS and >2 years from diagnosis were the factors caused higher total score of CoQoLo core domein. Conclusions: Survivors with MPM had physical and psychological difficulties. Even the survivors with good PS had functional difficulty. Individualized supports are required for survivors with MPM. Legal entity responsible for the study: Nobukazu Fujimoto Funding: Ministry of Health, Labour and Welfare, Japan Disclosure: All authors have declared no conflicts of interest.