Independent prognostic value of the EORTC QLQ-C30 summary score on all-cause mortality: Results from the population-based PROFILES registry

Olga Husson, B.H. de Rooij, Jacobien M. Kieffer, S. Oerlemans, Floortje Mols, Neil K. Aaronson

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Health-related quality of life (HRQoL) has been shown to be a prognostic factor for cancer survival in randomized clinical trials. It is questioned whether this association also holds in the “real world” and which HRQoL scores as measured by the EORTC QLQ-C30 are the best prognosticators. The aims of the present observational, population-based study were to: (1) investigate the association of HRQoL with all-cause mortality; and (2) determine which QLQ-C30 scores (the summary score covering all HRQoL domains, the global QoL or the physical functioning scale) exhibits the strongest association with all-cause mortality. Methods: 
Between 2008 and 2015, cancer patients (colon, rectum, melanoma, basal/squamous cell, endometrial, ovarian, prostate, thyroid, Hodgkin, non-Hodgkin lymphoma, chronic lymphocytic leukemia, multiple myeloma) were invited to participate in PROFILES (‘Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship’) disease-specific registry studies (response 69%). In this secondary analysis on a collated patient sample with complete data (n = 6895) multivariate Cox proportional hazard regression models were used to analyze the association between the QLQ-C30 scores and all-cause mortality. 
In the overall regression model including sociodemographic and clinical variables, the QLQ-C30 summary score was associated significantly with all-cause mortality (HR = 0.77; 95%CI = 0.72-0.82; p < 0.01). In stratified analyses, significant associations between the summary score and all-cause mortality were found for colon, rectal, prostate cancer, non-Hodgkin lymphoma, chronic lymphocytic leukemia and multiple myeloma only. The summary score had a stronger association with all-cause mortality than the global QoL (HR = 0.82; 95%CI = 0.78-0.85; p < 0.01) and the physical functioning scales (HR = 0.81; 95%CI = 0.78-0.84; p < 0.01). 
Our results indicate that, in a population-based setting, HRQoL, as assessed by the summary score of the QLQ-C30, has prognostic value for a number of cancer patient populations above and beyond that provided by clinical and sociodemographic variables.
Original languageEnglish
Number of pages1
JournalJournal of Clinical Oncology
Issue number15
Publication statusPublished - 2018


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