Self-Reported Quality of Life for Predicting Mortality in Renal Cell Carcinoma
Quality of life (QOL) in cancer patients has gained increasing attention and may provide prognostic value above and beyond traditional demographic and disease parameters. We evaluate the utility of self-reported QOL to predict mortality in patients with renal cell carcinoma (RCC).
The Medicare Health Outcomes Survey was linked to the SEER database to identify patients who completed a QOL questionnaire after the diagnosis of RCC from 1998-2014. Mental component summary (MCS) and physical component summary (PCS) scores were classified as high (≥50) or low (
A total of 1494 patients with a median age of 73.4 years (IQR 68.8-79.3) at survey completion were included. Median follow-up was 5.6 years (IQR 4.0-8.3). There were 747 deaths, of which 139 were due to RCC. Cox regression showed that each additional MCS and PCS point reduced the hazard of ACM by 1.3% (95% CI 0.981-0.993, PPP=0.02), 4.55 (95% CI 1.57-13.18, P=0.005), and 3.11 (95% CI 1.35-7.16, P=0.008), respectively, compared to Group 1 [Figure A]. The SHR for non-RCC mortality in Groups 2, 3, and 4 were 1.50 (95% CI 1.16-1.94, P=0.002), 1.03 (95% CI 0.59-1.78, P=0.9), and 1.83 (95% CI 1.41-2.38, P[Figure B].
Self-reported QOL metrics can be used to predict ACM in RCC patients with good accuracy. Lower PCS and MCS scores led to higher rates of ACM, even after accounting for differences in disease, demographics, and comorbidity. Furthermore, non-RCC mortality was associated more with low physical health rather than low mental health.