Quality of Life and Adverse Events: Prognostic Relationships in Long-Term Ovarian Cancer Survival
Menée auprès de patientes ayant survécu plus de 8 ans (260 cas) ou moins de 5 ans (260 cas) à un cancer de l'ovaire, cette étude analyse chez ces deux groupes la qualité de vie, la survenue d'événements indésirables et l'association entre la qualité de vie et la survie à long terme
BACKGROUND : There is a critical need to identify patient characteristics associated with long-term ovarian cancer survival. METHODS : Quality of life (QOL), measured by the Functional Assessment of Cancer Therapy-Ovarian-Trial Outcome Index (FACT-O-TOI), including physical, functional and ovarian-specific subscales, was compared between long-term (LTS) (8+ years) and short-term (STS) (<5 years) survivors of GOG 218 at baseline, before cycles 4, 7, 13, 21, and 6 months post-treatment using linear and longitudinal mixed models adjusted for covariates. Adverse events (AEs) were compared between survivor groups at each assessment using generalized linear models. All p-values are two-sided. RESULTS : QOL differed statistically significantly between STS (N = 1115) and LTS (N = 260) (p < .001). Baseline FACT-O-TOI and FACT-O-TOI change were independently associated with long-term survival (OR = 1.05, 95% CI = 1.03–1.06 and OR = 1.06, 95% CI = 1.05–1.07, respectively). A 7-point increase in baseline QOL was associated with a 38.0% increase in probability of LTS, while a 9-point increase in QOL change was associated with a 67.0% increase in odds for LTS. QOL decreased statistically significantly with increasing AE quartiles (cycle 4 quartiles: 0–5 v. 6–8 v. 9–11 v. ≥12 AEs, p = .01; cycle 21 quartiles: 0–2 v. 3 v. 4–5 v. ≥6 AEs, p = .001). Further, LTS reported statistically significantly better QOL compared to STS (p = .03 and p = .01, cycles 4 and 21, respectively), with similar findings across higher AE grades. CONCLUSION : Baseline and longitudinal QOL change scores distinguished long versus short-term survivors and are robust prognosticators for long term survival. Results have trial design and supportive care implications, providing meaningful prognostic value in this understudied population.