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Influence of pretreatment quality of life on prognosis in patients with urothelial carcinoma

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Abstract

Background

We investigated the association between the pretreatment quality of life (QOL) and overall survival (OS) in patients with urothelial carcinoma (UC), as the influence of pretreatment QOL on prognosis remains unclear in patients with localized and metastatic UC.

Methods

Between June 2013 and May 2019, we retrospectively investigated 205 patients with UC who received radical cystectomy or nephroureterectomy for non-metastatic UC (M0 group) or systemic chemotherapy for metastatic UC (M1 group). Patients answered the European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (QLQ-C30) before the treatments. Patients were stratified into two groups: QOL high and low according to the optimal cutoff scores which were defined by receiver operating characteristic curve. Inverse probability of treatment weighting (IPTW)-adjusted multivariate Cox regression analyses were performed to investigate the clinical implication of pretreatment QOL score on OS in patients with UC.

Results

The number of patients in the M0 and M1 groups was 125 and 80, respectively. Optimal cutoff values in global, fatigue, pain, appetite loss, physical, and role scores were < 50, > 33, > 33, > 16, < 80, and < 67, respectively. IPTW-adjusted multivariate Cox regression analyses revealed that appetite loss score indicated a significantly poorer OS in the M1 group. No significant association of QOL with OS was observed in the M0 group.

Conclusion

Pretreatment QOL of appetite loss may predict poor prognosis of patients with metastatic UC.

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Abbreviations

QOL:

Quality of life

UC:

Urothelial carcinoma

QLQ-C30:

European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire C30

ECOG PS:

Eastern Cooperative Oncology Group performance status

OS:

Overall survival

GCis:

Gemcitabine plus cisplatin

GCarbo:

Gemcitabine plus carboplatin

MVAC:

Methotrexate, vinblastine, doxorubicin, and cisplatin

ROC:

Receiver operating characteristic

HR:

Hazard ratio

95% CI:

95% Confidence interval

IQR:

Interquartile range

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Acknowledgements

The authors would like to thank Hiromichi Iwamura, Takuma Narita, Itsuto Hamano, Yuki Fujita, Yukie Nishizawa, and Satomi Sakamoto for their invaluable support in data collection. The authors would also like to thank Enago (www.enago.jp) for English language review.

Funding

This study was supported by Japan Society for the Promotion of Science (JSPS) KAENHI Grant Nos. 15H02563, 17K11119, and 18K09157 and 19H05556.

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Authors and Affiliations

  1. Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan

    Sappaya Suppanuntaroek, Shingo Hatakeyama, Naoki Fujita, Yuka Kubota, Yuichiro Suzuki, Teppei Okamoto, Yuki Tobisawa, Hayato Yamamoto, Kazuyuki Mori, Atsushi Imai, Yasuhiro Hashimoto & Chikara Ohyama

  2. Department of Urology, Queen Savang Vadhana Memorial Hospital, Si Racha, Thailand

    Sappaya Suppanuntaroek

  3. Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Tohru Yoneyama & Takahiro Yoneyama

Authors
  1. Sappaya Suppanuntaroek
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  2. Shingo Hatakeyama
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  3. Naoki Fujita
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Correspondence to Shingo Hatakeyama.

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Suppanuntaroek, S., Hatakeyama, S., Fujita, N. et al. Influence of pretreatment quality of life on prognosis in patients with urothelial carcinoma. Int J Clin Oncol 25, 362–369 (2020). https://doi.org/10.1007/s10147-019-01563-2

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  • DOI: https://doi.org/10.1007/s10147-019-01563-2

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