The usefulness and prognostic value of Memorial Symptom Assessment-Short Form and Condensed Memorial Symptom Assessment Scale in assessment of lung cancer patients

Abstract

Purpose: Lung cancer is associated with high level of symptoms and patient-reported symptoms have been rarely used as a prognostic score to predict patients survival.

Methods: Frequency and burden of symptoms in lung cancer patients were evaluated before the diagnosis with the Memorial Symptom Assessment-Short Form (MSAS-SF) and Condensed Memorial Symptom Assessment Scale (CMSAS) questionnaires. Performance status, stage of disease, serum albumin, and C-reactive protein (CRP) levels were recorded. Patients were staged according to 8th TNM classification. A survival analysis was applied.

Results: The mean age of 116 patients (adenocarcinoma 51, squamous cell 43, non-small cell 5, small cell 17) was 65.2 ± 10.1 (28-87) years. The most common seen physical and psychological symptoms were cough (86.3%), lack of energy (74.3%), dyspnea (70.1%), and feeling sad (61.5%), feeling nervous (61.5%), and worrying (53.8%). Total and subscores of MSAS and CMSAS are significantly higher in M1 disease than M0 disease. All MSAS-SF and CMSAS scores, but not MSAS-PSYCH and CMSAS-PSYCH, positively correlated with age, high serum CRP, white blood cells/neutrophils counts, and TNM stage, and negatively correlated with albumin levels, performance status, and overall survival (OS). Median survival was 77, 195, 370, and 579 days for the four prognostic interquartile groups according to CMSAS-SUM score (p < 0.0001).

Conclusion: MSAS-SF and CMSAS questionnaires can be useful tool for discriminating metastatic from non-metastatic disease in treatment-naïve patients with lung cancer. Since both questionnaires well correlated with OS and important prognostic factors, they can use to plan palliative care and to help for predicting survival of lung cancer patients.

Keywords: Assessment; Lung cancer; Performance status; Prognosis; Questionnaire; Symptoms; TNM stage.