TY - JOUR
T1 - Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types
T2 - a validation study
AU - Lim, Luigi
AU - Machingura, Abigirl
AU - Taye, Mekdes
AU - Pe, Madeline
AU - Coens, Corneel
AU - Martinelli, Francesca
AU - Alanya, Ahu
AU - Antunes, Stéphanie
AU - Tu, Dongsheng
AU - Basch, Ethan
AU - Ringash, Jolie
AU - Brandberg, Yvonne
AU - Groenvold, Mogens
AU - Eggermont, Alexander
AU - Cardoso, Fatima
AU - Van Meerbeeck, Jan
AU - Koller, Michael
AU - Van der Graaf, Winette T A
AU - Taphoorn, Martin J B
AU - Koekkoek, Johan A F
AU - Reijneveld, Jaap C
AU - Soffietti, Riccardo
AU - Velikova, Galina
AU - Bottomley, Andrew
AU - Flechtner, Henning
AU - Musoro, Jammbe
AU - EORTC Quality of Life Group, Brain tumour, Breast Cancer, Melanoma Group, Lung Cancer, Soft Tissue and Bone Sarcoma, Lymphoma, Gastrointestinal Tract Cancer, Head and Neck Cancer, Genito-Urinary Cancers, and Gynecological Cancer Groups
N1 - © 2025 The Authors.
PY - 2025
Y1 - 2025
N2 - 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.
AB - 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.
U2 - 10.1016/j.eclinm.2025.103153
DO - 10.1016/j.eclinm.2025.103153
M3 - Journal article
C2 - 40201799
SN - 2589-5370
VL - 82
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 103153
ER -