Gender Differences in Symptom Burden, Functional Performance and Global Quality of Life of Lung Cancer Patients Receiving Inpatient versus Outpatient Treatment

Figures & data

Table 1 Baseline Characteristics

Age (median, range)	Total (n = 198)	Female (n = 73)	Male (n = 125)	Inpatient (n = 113)	Outpatient (n = 85)
	64.5 (20–89)	64 (39–89)	65 (20–86)	64.5 (20–89)	64.5 (43–81)
Smoking status
Non-smoker/Ex-Smoker	26	16	10	16	10
Smoker	165	55	110	92	73
Missing Data	7			5	2
Disease
SCLC (all stages)	48	14	34	39	9
NSCLC (all stages)	150	59	91	74	76
Therapy approach
Curative (= UICC I–III)	68	27	41	44	24
Palliative (= UICC IV)	130	46	84	69	61
Comorbidity
Yes	167	59	108	94	73
No	31	14	17	19	12

Abbreviations: SCLC, small cell lung cancer; NSCLC, non-small cell lung cancer; UICC, Union for International Cancer Control.

Table 2 First-Line Therapy

	Total (n = 198)	Female (n = 73)	Male (n = 125)	Inpatient (n = 113)	Outpatient (n = 85)
Chemotherapy	58 (29.3%)	24 (32.9%)	34 (27.2%)	38 (33.6%)	20 (23.5%)
Immunochemotherapy	75 (37.9%)	23 (31.5%)	52 (41.6%)	32 (28.3%)	43 (50.6%)
Immunotherapy	13 (6.6%)	5 (6.8%)	8 (6.4%)	6 (5.3%)	7 (8.2%)
Radiotherapy	5 (2.5%)	2 (2.7%)	3 (2.4%)	5 (4.4%)	0
Radiochemotherapy	28 (14.1%)	10 (13.7%)	18 (14.4%)	19 (16.8%)	9 (10.6%)
Target therapy	11 (5.6%)	8 (11.0%)	3 (2.4%)	6 (5.3%)	5 (5.9%)
Operation	3 (1.5%)	1 (1.4%)	2 (1.6%)	2 (1.8%)	1 (1.2%)
No statement	5 (2.5%)	0	5 (4.0%)	5 (4.4%)	0

Abbreviation: N, number.

Table 3 Estimated Marginal Means of the EORTC QLQ-C30 and the QLQ-LC29

QLQ-C30	Inpatient	Men (n = 80)	p-value	Outpatient	Men (n = 45)	p-value
	Women (n = 34)	Mean		Women (n = 41)	Mean
	Mean			Mean
Global quality of life	57.5 (49.4–65.6)	46.1 (40.1–52.1)	0.016	66.5 (58.2–74.8)	64.0 (56.0–72.0)	0.603
Physical functioning	60.0 (51.6–68.5)	64.5 (58.3–70.8)	0.358	78.2 (69.6–86.8)	75.6 (67.2–83.9)	0.602
Role functioning	49.2 (37.4–61.0)	54.7 (45.9–63.4)	0.419	65.8 (53.8–77.9)	67.8 (56.2–79.4)	0.782
Emotional functioning	59.8 (50.6–69)	60.0 (53.1–66.8)	0.973	63.0 (53.6–72.4)	68.9 (59.9–78.0)	0.286
Cognitive functioning	71.1 (61.1–81.0)	72.0 (64.6–79.3)	0.870	74.8 (64.7–85.0)	81.9 (72.1–91.7)	0.230
Social functioning	59.5 (48.2–70.9)	60.1 (51.7–68.5)	0.929	65.5 (54.0–77.1)	63.9 (52.7–75.0)	0.804
Fatigue	53.2 (43.1–63.2)	49.1 (41.6–56.5)	0.481	42.9 (32.7–53.2)	39.3 (29.4–49.2)	0.549
Nausea/vomiting	17.6 (10.8–24.4)	9.3 (4.3–14.4)	0.037	11.4 (4.5–18.4)	8.7 (2.0–15.4)	0.497
Pain	29.0 (17.2–40.7)	35.6 (26.9–44.3)	0.328	21.3 (9.3–33.2)	20.7 (9.2–32.3)	0.938
Dsypnea	46.0 (34.2–57.9)	44.2 (35.4–53.0)	0.789	41.1 (29.0–53.2)	40.1 (28.4–51.7)	0.883
Appetite loss	35.6 (22.8–48.5)	31.7 (22.2–41.3)	0.596	17.5 (4.4–30.7)	17.3 (4.7–30.0)	0.976
Insomnia	42.1 (39.3–55.0)	36.4 (26.8–45.9)	0.435	32.1 (19.0–45.3)	26.8 (14.1–39.5)	0.491
Constipation	25.9 (14.0–37.9)	26.1 (17.3–35.0)	0.980	21.7 (9.5–33.9)	15.4 (3.6–27.1)	0.377
Diarrhea	15.5 (6.0–24.9)	17.6 (10.6–24.6)	0.700	8.0 (−1.6–17.6)	7.7 (−1.6–17.0)	0.960
Financial difficulties	16.9 (5.8–28.0)	24.3 (16.1–32.6)	0.248	20.1 (8.7–31.4)	26.4 (15.4–37.4)	0.343
QLQ-LC29	Inpatient	Men (n=80)	p-value	Outpatient	Men (n=45)	p-value
	Women (n=34)	Mean		Women (n=41)	Mean
	Mean			Mean
Cough	36.1 (25.3–46.9)	39.0 (31.0–47.0)	0.644	29.2 (18.2–40.2)	27.5 (17.0–38.1)	0.791
Shortness of breath	34.4 (25.0–43.8)	36.0 (29.0–43.0)	0.769	26.8 (17.2–36.5)	28.0 (18.8–37.3)	0.829
Hair loss	40.0 (27.8–52.2)	21.7 (12.7–30.8)	0.010	44.9 (32.5–57.3)	37.2 (25.2–49.1)	0.288
Fear of progression	62.9 (51.2–74.7)	64.2 (55.5–73.0)	0.855	60.8 (48.8–72.8)	49.3 (37.7–60.9)	0.104
Surgery related symptoms	36.8 (9.1–64.6)	33.5 (14.3–52.8)	0.824	35.1 (7.8–62.5)	26.3 (−0.4–53.0)	0.529
Sideeffects	21.2 (16.4–25.9)	20.7 (17.2–24.2)	0.859	17.3 (12.4–22.1)	17.5 (12.8–22.2)	0.943
Coughblood	3.7 (−3.2–10.7)	7.7 (2.6–12.9)	0.315	3.3 (−3.8–10.3)	4.8 (−2.04–11.6)	0.716
Sore mouth or tongue	12.7 (4.6–20.8)	6.0 (0–12.0)	0.149	1.2 (−7.0–9.5)	13.5 (5.5–21.4)	0.012
Problems swallowing	17.5 (8.1–26.9)	12.6 (5.7–19.6)	0.373	6.0 (−3.6–15.6)	11.3 (2.1–20.6)	0.344
Tingling hands or feet	28.2 (16.3–40.0)	25.8 (17.0–34.6)	0.730	27.7 (15.6–39.8)	26.5 (14.8–38.1)	0.857
Chest pain	16.8 (6.7–26.8)	27.4 (20.0–34.9)	0.067	18.3 (8–28.5)	18.6 (8.8–28.5)	0.950
Shoulder pain	26.0 (14.8–37.3)	25.5 (17.2–33.8)	0.933	28.8 (17.3–40.2)	18.0 (6.9–29.1)	0.111
Painbody	28.0 (16.0–40.0)	28.0 (19.2–36.9)	0.996	28.5 (16.2–40.9)	21.0 (9.2–32.8)	0.299
Dizziness	32.4 (21.9–42.9)	22.7 (9.7–25.3)	0.01	17.5 (12.0–33.4)	17.9 (7.6–28.2)	0.450

Notes: All scales range from 0 to 100. In the symptom scales, a higher score is associated with a higher symptom burden. In the functioning scales the reverse is true, higher scores denote better performance.All significant results are marked bold.

Abbreviations: EORTC, European Organization for Research and Treatment; n, number.

Figure 1 Cumulated symptom scales (EORTC QLQ-C30 and LC29) (n=198). Marked in diagram, median, statistical mean (x) and smallest cumulative value (I).

Abbreviations: EORTC, European Organization for Research and Treatment; n, number.

Figure 2 Cumulated function scales (EORTC QLQ-C30 and LC29) (n = 198). Marked in diagram, median, statistical mean (x) and smallest cumulative value (I).

Abbreviations: EORTC, European Organization for Research and Treatment; n = number.

Figure 3 Quality of life separated by gender and inpatients versus outpatients (Estimated marginal means of the EORTC QLQ-C30). The error bars show the 95% percentile. p-value women inpatient/outpatient=0.095. p-value men inpatient/outpatient <0.001.

Abbreviation: EORTC, European Organization for Research and Treatment.