Background

Accumulating evidence of trials demonstrates that patient-reported health-related quality of life (HRQoL) at diagnosis is prognostic for overall survival (OS) in oesophagogastric cancer. However, real-world data are lacking. Moreover, differences in disease stages and tumour-specific symptoms are usually not taken into consideration. The aim of this population-based study was to assess the prognostic value of HRQoL, including tumour-specific scales, on OS in patients with potentially curable and advanced oesophagogastric cancer.

Methods

Data were derived from the Netherlands Cancer Registry and the patient reported outcome registry (POCOP). Patients included in POCOP between 2016 and 2018 were stratified for potentially curable (cT1-4aNallM0) or advanced (cT4b or cM1) disease. HRQoL was measured with the EORTC QLQ-C30 and the tumour-specific OG25 module. Cox proportional hazards models assessed the impact of HRQoL, sociodemographic and clinical factors (including treatment) on OS.

Results

In total, 924 patients were included. Median OS was 38.9 months in potentially curable patients (n = 795) and 10.6 months in patients with advanced disease (n = 129). Global Health Status was independently associated with OS in potentially curable patients (HR 0.89, 99%CI 0.82–0.97), together with several other HRQoL items: appetite loss, dysphagia, eating restrictions, odynophagia, and body image. In advanced disease, the Summary Score was the strongest independent prognostic factor (HR 0.75, 99%CI 0.59–0.94), followed by fatigue, pain, insomnia and role functioning.

Conclusion

In a real-world setting, HRQoL was prognostic for OS in patients with potentially curable and advanced oesophagogastric cancer. Several HRQoL domains, including the Summary Score and several OG25 items, could be used to develop or update prognostic models.

中文翻译：

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患者报告的食管胃癌生存质量的预后价值：基于人群的 POCOP 研究分析

 背景

越来越多的试验证据表明，患者诊断时报告的健康相关生活质量 (HRQoL) 可预测食管胃癌的总生存期 (OS)。然而，缺乏真实世界的数据。此外，通常不考虑疾病阶段和肿瘤特异性症状的差异。这项基于人群的研究的目的是评估 HRQoL（包括肿瘤特异性量表）对可能治愈的晚期食管胃癌患者 OS 的预后价值。

 方法

数据来自荷兰癌症登记处和患者报告结果登记处 (POCOP)。 2016 年至 2018 年间纳入 POCOP 的患者根据潜在可治愈（cT1-4aNallM0）或晚期（cT4b 或 cM1）疾病进行分层。 HRQoL 使用 EORTC QLQ-C30 和肿瘤特异性 OG25 模块进行测量。 Cox 比例风险模型评估了 HRQoL、社会人口学和临床因素（包括治疗）对 OS 的影响。

 结果

总共包括 924 名患者。潜在可治愈患者 ( n = 795) 的中位 OS 为 38.9 个月，晚期疾病患者 ( n = 129) 的中位 OS 为 10.6 个月。全球健康状况与潜在可治愈患者的 OS 独立相关（HR 0.89，99%CI 0.82-0.97），以及其他几个 HRQoL 项目：食欲减退、吞咽困难、饮食限制、吞咽痛和身体形象。在晚期疾病中，总结评分是最强的独立预后因素（HR 0.75，99%CI 0.59-0.94），其次是疲劳、疼痛、失眠和角色功能。

 结论

在现实世界中，HRQoL 可预测可治愈的晚期食管癌患者的 OS。多个 HRQoL 领域（包括汇总评分和多个 OG25 项目）可用于开发或更新预后模型。