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

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.

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.

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.

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

International journal of clinical oncology. 2019 Oct 26 [Epub ahead of print]

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

Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan., Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. ., Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Read an Expert Commentary by Bishoy Faltas, MD