Health-Related Quality of Life in Newly Diagnosed Cancer Patients Prior to First Outpatient Chemotherapy: A Cross-Sectional Study.

Abstract

Introduction: Cancer imposes substantial physical and psychological burdens that negatively affect patients' health-related quality of life (HRQoL). Assessing HRQoL prior to chemotherapy initiation is essential for tailoring early supportive care strategies.

Objective: To describe the characteristics and identify the factors associated with HRQoL in newly diagnosed cancer patients immediately before initiating outpatient chemotherapy.

Method: This cross-sectional study included adults with newly diagnosed stage I-III cancer scheduled to begin outpatient chemotherapy at a Brazilian cancer referral center. Sociodemographic and tumor-related data were obtained using a structured questionnaire. HRQoL was assessed with the EQ-5D-3L instrument. Descriptive and bivariate analyses were performed using Fisher's exact test.

Results: Eighty-four patients were included (mean age: 57.68 years); most were female (72.62%), of mixed ethnicity (40.48%), had completed only primary education (48.81%), and were married (51.19%). The average time from diagnosis to treatment initiation was 120 days, and 60.71% reported comorbidities. Breast cancer was the most common diagnosis (57.14%), predominantly at Stage II (57.14%). The mean EQ-5D-3L index score was 77.79. Comorbidities were significantly associated with impaired mobility (p = .009), and female patients reported significantly more anxiety and depression than males (p = .005). Inflammatory markers revealed that most patients had low neutrophil-to-lymphocyte ratio (76.54%), low platelet-to-lymphocyte ratio (72.84%), and elevated C-reactive protein (CRP; 84.52%). In the multivariate analysis, the presence of comorbidities remained significantly associated with worse mobility (OR = 5.456; 95% CI [1.205-24.707]; p = .028), and male sex was independently associated with lower levels of anxiety and depression (OR = 0.206; [0.067-0.634]; p = .006). A nonsignificant trend was also observed between higher CRP levels and increased pain (OR = 2.800; [0.824-9.510]; p = .099).

Conclusions: Patients with newly diagnosed cancer experience impaired HRQoL even before starting chemotherapy. Comorbidities were associated with worse mobility, and female patients reported higher levels of anxiety and depression. These findings support the need for early multidisciplinary care to mitigate functional and emotional burdens prior to treatment.