Association Between Symptoms and Their Severity with Survival Time in Hospitalized Patients with Far Advanced Cancer

Objective: To assess the significance of symptoms and their severity for predicting survival of hospitalized patients with far advanced cancer.

Methods: Two hundred fifty-six patients with far advanced cancer at the Cancer Center of Tongji Hospital, China were assessed by the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C). A Cox regression model was used to determine symptoms that could predict survival time. The log-rank test was used to compare the survival of patients accompanied by significant symptoms at different intensities.

Results: Median survival was 49 days. Fatigue was the most common and severe symptom, followed by lack of appetite, disturbed sleep, and pain. Multivariate analysis showed that fatigue, shortness of breath, lack of appetite, and feeling sad were independent prognostic factors for survival time (p  < 0.05), with a hazard ratio of dying of 1.39, 1.13, 1.33, and 1.16, respectively. The survival time for patients with different intensities of the four symptoms showed significant differences (p  <  0.01).

Conclusions: Fatigue, lack of appetite, feeling sad, and shortness of breath could be predictive factors for survival time of hospitalized patients with far advanced cancer. The more severe these symptoms are, the shorter will be survival time.