Health-related quality of life and its determinants in patients with metastatic renal cell carcinoma

Based on improvements of progression-free survival (PFS), new agents for metastatic renal cell carcinoma (mRCC) have been approved. It is assumed that one of the benefits is a delay in health-related quality of life (HRQoL) deterioration as a result of a delay in progression of disease. However, little data are available supporting this relationship. This study aims to provide insight into the most important determinants of HRQoL (including progression of disease) of patients with mRCC.

A patient registry (PERCEPTION) was created to evaluate treatment of patients with (m)RCC in the Netherlands. HRQoL was measured, using the EORTC QLQ-C30 and EQ-5D-5L, every 3 months in the first year of participation in the study, and every 6 months in the second year. Participation started as soon as possible following a diagnosis of (m)RCC. Random effects models were used to study associations between HRQoL and patient and disease characteristics, symptoms and treatment.

Eighty-seven patients with mRCC completed 304 questionnaires. The average EORTC QLQ-C30 global health status was 69 (SD, 19) before progression and 61 (SD, 22) after progression of disease. Similarly, the average EQ-5D utility was 0.75 (SD, 0.19) before progression and 0.66 (SD, 0.30) after progression of disease. The presence of fatigue, pain, dyspnoea, and the application of radiotherapy were associated with significantly lower EQ-5D utilities.

Key drivers for reduced HRQoL in mRCC are disease symptoms. Since symptoms increase with progression of disease, targeted therapies that increase PFS are expected to postpone reductions in HRQoL in mRCC.

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 2017 Sep 15 [Epub ahead of print]

S de Groot, W K Redekop, M M Versteegh, S Sleijfer, E Oosterwijk, L A L M Kiemeney, C A Uyl-de Groot

Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands. ., Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P. O. Box 1738, 3000 DR, Rotterdam, The Netherlands., Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, P. O. Box 5201, 3008 AE, Rotterdam, The Netherlands., Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, P. O. Box 9101, 6500 HB, Nijmegen, The Netherlands.