Quality of life scores demonstrate prognostic value in ovarian cancer
Quality of life (QoL) scores, particularly in the domains of physical function and abdominal/gastrointestinal symptom, provide additional prognostic information to survival prediction in platinum-resistant ovarian cancer, according to a study.
Researchers used data from the AURELIA study involving 326 patients randomized to receive chemotherapy with or without bevacizumab to identify baseline QoL domains (EORTC QLQ-C30 and OV28) significantly associated with overall survival. Risk categories for physical function and abdominal/gastrointestinal symptom were defined as good, medium or low.
Univariable analysis showed that all domains, with the exception of cognitive function, predicted overall survival, but only physical function and abdominal/gastrointestinal symptom scores remained significantly associated with survival in multivariable models (p<0.001 for both).
In patients with high (score <67), medium (67 to 93) and low (>93) risk categories for physical function, the respective median overall survival was 11.0, 14.7 and 19.3 months (p<0.001). In an independent cohort (CARTAXHY; n=136), the corresponding median overall survival was 7.9, 16.2 and 23.9 months (p<0.001).
In patients with high (>44), medium (13 to 44) and low (<13) risk categories for abdominal/gastrointestinal symptoms, the respective median overall survival was 11.9, 14.3 and 19.7 months in the AURELIA cohort (p<0.001) and 10.5, 19.6 and 24.1 months in CARTAXHY (p=0.02).
Physical function (p=0.02) and abdominal/gastrointestinal symptoms (p=0.03) remained independent prognostic factors for overall survival after controlling for clinicopathologic factors. The C-statistic of the full model was 0.71. Separately, the respective C-statistics for quality of life factors, patient factors and disease factors were 0.61, 0.61 and 0.67.
The present data indicate that physical function and abdominal/gastrointestinal symptom scores can improve predictions of overall survival in platinum-resistant ovarian cancer when compared with clinicopathologic factors alone.
Researchers said the additional prognostic information could improve trial stratification, patient-doctor communication about prognosis and clinical decision making.