Does Pre-Treatment Quality of Life Impact the Prognosis of Patients with Urothelial Carcinoma? - Expert Commentary

The relationship between the baseline quality of life (QOL) and clinical outcomes for urothelial cancer (UC) patients is not well defined. A recent study published by Suppanuntaroek et al. investigated the relationship between pre-treatment quality of life (QOL) and overall survival (OS) in UC patients. The authors included 125 non-metastatic UC patients who underwent a radical cystectomy or nephroureterectomy for non-metastatic UC (M0 group) and 80 metastatic UC who received chemotherapy for metastatic UC (M1 group) between June 2013 and May 2019.

The investigators measured the pre-treatment QOL by administering the European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (QLQ-C30) to patients before the treatments. All the scales were converted to linear QOL scores (range 0 to 100). The investigators then used the receiver operating characteristic curve to two groups with higher and lower pre-treatment QOL scores (fatigue, pain, appetite loss, physical functioning, and role functioning scores). They used inverse probability of treatment weighting (IPTW)-adjusted multivariate Cox regression analyses to define the relationship between pre-treatment QOL score and OS.

The study found no significant association between QOL with OS in the M0 group. In the M1 group, pre-treatment appetite loss score was significantly associated with lower OS. Incorporating QOL measurements into future clinical trials for clinically-localized and metastatic UC patients will improve our understanding of QOL scores as prognostic and predictive factors.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York City, New York


1. Suppanuntaroek, Sappaya, Shingo Hatakeyama, Naoki Fujita, Yuka Kubota, Yuichiro Suzuki, Teppei Okamoto, Yuki Tobisawa et al. "Influence of pretreatment quality of life on prognosis in patients with urothelial carcinoma." International journal of clinical oncology 25, no. 2 (2020): 362-369.

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