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The added value of health-related quality of life as a prognostic indicator of overall survival and progression-free survival in glioma patients: a meta-analysis based on individual patient data from randomised controlled trials
Leiden Univ, Netherlands.
Leiden Univ, Netherlands; Haaglanden Med Ctr, Netherlands.
Netherlands Canc Inst, Netherlands.
Univ Hosp Bonn, Germany; Maastricht Univ, Netherlands; Maastricht Univ, Netherlands.
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2019 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 116, p. 190-198Article in journal (Refereed) Published
Abstract [en]

Objective: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of glioma patients, besides known prognostic factors. Methods: We included individual baseline data from previously published randomised controlled trials (RCTs) in glioma patients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices. Results: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS). Conclusion: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small. (C) 2019 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2019. Vol. 116, p. 190-198
Keywords [en]
Glioma; Health-related quality of life (HRQoL); Prognostic factor; Brain tumour; Survival
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-158938DOI: 10.1016/j.ejca.2019.05.012ISI: 000473270800022PubMedID: 31203194OAI: oai:DiVA.org:liu-158938DiVA, id: diva2:1338191
Note

Funding Agencies|European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group

Available from: 2019-07-20 Created: 2019-07-20 Last updated: 2019-07-20

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Malmström, Annika

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Division of Cell BiologyFaculty of Medicine and Health SciencesDepartment of Advanced Home Care in Linköping
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