European Organisation for Research and Treatment of Cancer (EORTC) and the Canadian Cancer Trials Group have published a paper in Cancer(1) on a study to validate an association between baseline health-related quality of life (HRQOL) scores and survival. The study also assessed the additional prognostic value of HRQOL with respect to demographic and clinical indicators.
Over the years, the impact of medical treatment has been measured by overall survival, disability or cure. However, recently, HRQOL has been used to measure the outcome of treatment. Studies have shown that several HRQOL scales were prognostic for overall survival.
Pooled data, from 17 randomized controlled trials opened by the Canadian Cancer Trials Group between 1991 and 2004, included survival and baseline HRQOL data from 3606 patients with 8 different cancer sites. The data included sex, age, World Health Organization performance status distant metastases and 15 EORTC Core Quality-of-Life Questionnaire (QLQ-C30) scales.
HRQOL parameters such as global health status, dyspnea and appetite loss were independent prognostic factors in addition to the demographic and clinical variables. When assessing these variables with the clinical variables, results showed an added relative prognostic value of 5% for survival.
These results definitively validate previous findings showing that baseline HRQOL, as measured on subscales of the EORTC QLQ-C30, is prognostic for overall survival in cancer patients independently of the cancer type. Moreover, prognostic accuracy is improved when assessing both HRQOL and clinical variables.
“The findings confirm other study results, that health related quality of life can help in predicting the patient’s survival,” said Dr Andrew Bottomley, Assistant Director and Head, Quality of Life Department at EORTC, Brussels Belgium. “In the future, further studies are needed to understand why HRQOL ratings predict survival, and to determine how to use this information in interventions and clinical care.”
(1) Quality of life as a prognostic indicator of survival: A pooled analysis of individual patient data from Canadian Cancer Trials Group clinical trials. Ediebah DE, Quinten C, Coens C, Ringash J, Dancey J, Zikos E, Gotay C, Brundage M, Tu D ,Flechtner HH, Greimel E, Reeve BB, Taphoorn M, Reijneveld J, Dirven L, Bottomley A; Canadian Cancer Trials Group and the European Organization for Research and Treatment of Cancer. Cancer. 2018 Jun 15. doi: 10.1002/cncr.31556. [Epub ahead of print]