Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study.

IF 9.6 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

EClinicalMedicine Pub Date : 2025-03-21 eCollection Date: 2025-04-01 DOI:10.1016/j.eclinm.2025.103153

Luigi Lim, Abigirl Machingura, Mekdes Taye, Madeline Pe, Corneel Coens, Francesca Martinelli, Ahu Alanya, Stéphanie Antunes, Dongsheng Tu, Ethan Basch, Jolie Ringash, Yvonne Brandberg, Mogens Groenvold, Alexander Eggermont, Fatima Cardoso, Jan Van Meerbeeck, Michael Koller, Winette T A Van der Graaf, Martin J B Taphoorn, Johan A F Koekkoek, Jaap C Reijneveld, Riccardo Soffietti, Galina Velikova, Andrew Bottomley, Henning Flechtner, Jammbe Musoro

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引用次数: 0

Abstract

Background: A pooled data analysis by Quinten et al. (2009) found three European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) health-related quality of life (HRQoL) scales to be prognostic for survival: physical functioning, pain and appetite loss. This study aims to replicate these findings in an independent data set comprising a broader cancer population.

Methods: Data were obtained from 46 clinical trials across three cancer research networks conducted between 1996 and 2013 that assessed HRQoL using the EORTC QLQ-C30. A stratified Cox proportional hazards model was employed to assess the prognostic significance of baseline QLQ-C30 scale scores on overall survival, adjusting for socio-demographic and clinical variables. Stepwise model selection was done at 5% significance level. Model stability and prognostic accuracy were evaluated via bootstrapping and the C index respectively.

Findings: Data from 16,210 patients reporting HRQoL at baseline, spanning 17 cancer types, was used. The stratified multivariable model confirmed that better physical functioning (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.93-0.96), lower pain (HR, 1.02; 95% CI, 1.01-1.03), and appetite loss (HR, 1.04; 95% CI, 1.03-1.05) were significantly associated with survival. Additionally, global health status/QoL, dyspnoea, emotional and cognitive functioning were found to be prognostic for survival. This final model, encompassing sociodemographic, clinical, and HRQoL variables, achieved a corrected C index of 0.74, marking a 48% enhancement in discriminatory ability. Bootstrap evaluation indicated no major instability issues.

Interpretation: These results support previous findings that baseline physical functioning, pain, and appetite loss scores, along with four other scales from the EORTC QLQ-C30, predict survival in cancer patients.

Funding: EORTC Quality of Life Group.

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基线EORTC QLQ-C30评分对涵盖17种癌症类型的46项临床试验的总生存期的预后价值：一项验证研究

背景：Quinten等人（2009年）的一项汇总数据分析发现，欧洲癌症研究和治疗组织生活质量问卷核心30（EORTC QLQ-C30）中的三个健康相关生活质量（HRQoL）量表对生存有预示作用：身体机能、疼痛和食欲不振。本研究的目的是在一个包含更广泛癌症人群的独立数据集中复制这些发现：研究数据来自 1996 年至 2013 年间在三个癌症研究网络中进行的 46 项临床试验，这些试验使用 EORTC QLQ-C30 评估了 HRQoL。采用分层考克斯比例危险模型评估基线QLQ-C30量表评分对总生存期的预后意义，并对社会人口学和临床变量进行调整。在5%的显著性水平下进行逐步模型选择。模型稳定性和预后准确性分别通过自引导和 C 指数进行评估：研究使用了 16210 名基线报告 HRQoL 的患者的数据，涵盖 17 种癌症类型。分层多变量模型证实，较好的身体机能（危险比 [HR]，0.94；95% 置信区间 [CI]，0.93-0.96）、较轻的疼痛（HR，1.02；95% CI，1.01-1.03）和食欲不振（HR，1.04；95% CI，1.03-1.05）与生存显著相关。此外，总体健康状况/QoL、呼吸困难、情绪和认知功能也对存活率有预示作用。该最终模型包括社会人口学、临床和 HRQoL 变量，校正后的 C 指数为 0.74，标志着判别能力提高了 48%。Bootstrap评估表明没有重大的不稳定性问题：这些结果支持了之前的研究结果，即基线身体功能、疼痛和食欲不振评分以及 EORTC QLQ-C30 的其他四个量表可预测癌症患者的生存期：EORTC 生活质量小组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

EClinicalMedicine Medicine-Medicine (all)

CiteScore

18.90

自引率

1.30%

发文量

506

审稿时长

22 days

期刊介绍： eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.