Patient-reported outcomes prognostic of cancer survival

Patient-reported outcomes (PROs) provide prognostic information for cancer survival, independent of other clinical factors, according to a study.

Researchers conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) that involved adult patients with cancer. The trials had to have at least one baseline PRO measure, overall survival (OS) as an outcome, and multivariate analyses adjusting for clinical and disease-related confounders conducted.

A total of 69 RCTs involving 44,030 patients were included in the systematic review, and 31 (44.9 percent) met the criteria for the meta-analysis. The primary outcome was the association between baseline PROs and OS.

Pooled data showed a link between higher global health status scores and quality of life and improved OS (hazard ratio [HR], 0.99, 95 percent confidence interval [CI], 0.98–0.99). Higher scores on the physical and role functioning scales were also correlated with better OS (physical: HR, 0.94, 95 percent CI, 0.92–0.96; role: HR, 0.96, 95 percent CI, 0.94–0.98).

On the contrary, higher symptom burden was associated with worse OS. Associations were observed for nausea and vomiting (HR, 1.12, 95 percent CI, 1.04–1.21), fatigue (HR, 1.05, 95 percent CI, 1.00–1.10), and pain (HR, 1.07, 95 percent CI, 1.04–1.11). The overall pooled effect indicated that patients with increasing individual symptom severity had a higher risk of mortality (HR, 1.03, 95 percent CI, 1.01–1.04).

No evidence of publication bias was identified with the Egger test.