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Is Baseline Quality of Life Useful for Predicting Survival With Hormone-Refractory Prostate Cancer? A Pooled Analysis of Three Studies of the European Organisation for Research and Treatment of Cancer Genitourinary Group

From the European Organization for Research and Treatment of Cancer Data Center, Brussels, Belgium; Department of Urology, Onze Lieve Vrouwe Gasthuis; Department of Urology, Academisch Medisch Centrum, Amsterdam; Department of Urology, Academisch Ziekenhuis Maastricht, Maastricht, the Netherlands; Department of Urology, Rudolfstiftung, Vienna, Austria; and Department of Oncology, Norwegian Radium Hospital, Oslo, Norway.

Address reprint requests to Laurence Collette, European Organisation for Research and Treatment of Cancer, Data Center–Biostatistics, Ave E. Mounier 83/11, B-1200 Brussels, Belgium; e-mail: lco{at}eortc.be

PURPOSE: Patients with symptomatic metastatic hormone-resistant prostate cancer (HRPC) survive a median of 10 months and are often regarded as a homogeneous group. Few prognostic factors have been identified so far. We examined whether baseline health-related quality of life (HRQOL) parameters assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) were independent prognostic factors of survival and whether they bring extra precision to the predictions achievable with models based on clinical and biochemical factors only.

PATIENTS AND METHODS: Data of 391 symptomatic (bone) metastatic HRPC patients from three randomized EORTC trials were used in multivariate Cox proportional hazards models. The significance level was set at = .05.

RESULTS: Of the 391 patients, 371 died, most of prostate cancer. Bone scan result, performance status, hemoglobin level, and insomnia and appetite loss as measured by the EORTC QLQ-C30 were independent predictors of survival. This model's area under the receiver operating curve was 0.65 compared with 0.63 without the two HRQOL factors.

CONCLUSION: Certain HRQOL sores, at baseline, seem to be predictors for duration of survival in HRPC. However, such measurements do not add to the predictive ability of models based only on clinical and biochemical factors.

Supported by grant Nos. 5U10-CA11488-30 through 5U10-CA11488-33 from the National Cancer Institute (Bethesda, MD).

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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