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. 2017 Oct;147(1):98-103.
doi: 10.1016/j.ygyno.2017.07.121. Epub 2017 Jul 23.

Quality of life is significantly associated with survival in women with advanced epithelial ovarian cancer: An ancillary data analysis of the NRG Oncology/Gynecologic Oncology Group (GOG-0218) study

N T Phippen  1 , A A Secord  2 , S Wolf  3 , G Samsa  3 , B Davidson  2 , A P Abernethy  4 , D Cella  5 , L J Havrilesky  2 , R A Burger  6 , B J Monk  7 , C A Leath 3rd  8
Affiliations

Quality of life is significantly associated with survival in women with advanced epithelial ovarian cancer: An ancillary data analysis of the NRG Oncology/Gynecologic Oncology Group (GOG-0218) study

N T Phippen et al. Gynecol Oncol. 2017 Oct.

Abstract

Objective: Evaluate association between baseline quality of life (QOL) and changes in QOL measured by FACT-O TOI with progression-free disease (PFS) and overall survival (OS) in advanced epithelial ovarian cancer (EOC).

Methods: Patients enrolled in GOG-0218 with completed FACT-O TOI assessments at baseline and at least one follow-up assessment were eligible. Baseline FACT-O TOI scores were sorted by quartiles (Q1-4) and outcomes compared between Q1 and Q2-4 with log-rank statistic and multivariate Cox regression adjusting for age, stage, post-surgical residual disease size, and performance status (PS). Trends in FACT-O TOI scores from baseline to the latest follow-up assessment were evaluated for impact on intragroup (Q1 or Q2-4) outcome by log-rank analysis.

Results: Of 1152 eligible patients, 283 formed Q1 and 869 formed Q2-4. Mean baseline FACT-O TOI scores were 47.5 for Q1 vs. 74.7 for Q2-4 (P<0.001). Q1 compared to Q2-4 had worse median OS (37.5 vs. 45.6months, P=0.001) and worse median PFS (12.5 vs. 13.1months, P=0.096). Q2-4 patients had decreased risks of disease progression (HR 0.974, 95% CI 0.953-0.995, P=0.018), and death (HR 0.963, 95% CI 0.939-0.987, P=0.003) for each five-point increase in baseline FACT-O TOI. Improving versus worsening trends in FACT-O TOI scores were associated with longer median PFS (Q1: 12.7 vs. 8.6months, P=0.001; Q2-4: 16.7 vs. 11.1months, P<0.001) and median OS (Q1: 40.8 vs. 16months, P<0.001; Q2-4: 54.4 vs. 33.6months, P<0.001).

Conclusions: Baseline FACT-O TOI scores were independently prognostic of PFS and OS while improving compared to worsening QOL was associated with significantly better PFS and OS in women with EOC.

Keywords: FACT-O TOI; NRG Oncology/GOG; Ovarian cancer; Quality of life; Survival.

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Conflict of interest statement

Disclosures: AS dz Genentech. AA discloses employment with Flatiron Health Inc. as well as serving on the board of directors and having stock ownership with Athenahealth Inc. AA also has received honoraria from Genentech and serves in a consulting or advisory role with BMS and Helsinn. BM discloses that St. Joseph's Hospital institution has received research grants from Genentech. BM has received honoraria for speaker bureaus as well as been a consultant for Roche/Genentech. CL discloses advisory board service for Celsion and Genentech. All remaining authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Inter-cohort comparison of PFS (A) and OS (B) between Q1 and Q2-4. Median PFS was similar between cohorts, Q1 (12.5 months) and Q2-4 (13.1 months). Patients in the Q2-4 cohort lived 8.1 months longer than Q1 counterparts (median OS of 45.6 months vs. 37.5 months).
Fig. 2
Fig. 2
Association between quality of life trendon PFS (A) and OS (B) within Q1. Median PFS for worsening compared with improving quality of life was 8.6 compared to 12.7 months while median OS for worsening compared with improving quality of life was 16 compared to 40.8 months. In Q2-4 the median PFS (C) for worsening compared with improving quality of life was 11.1 compared to 16.7 months while median OS (D) for worsening compared with improving quality of life was 33.6 compared to 54.4 months.
See this image and copyright information in PMC

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