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. 2018 Jan;27(1):115-124.
doi: 10.1007/s11136-017-1704-4. Epub 2017 Sep 15.

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

S de Groot  1   2 , W K Redekop  3 , M M Versteegh  3   4 , S Sleijfer  5 , E Oosterwijk  6 , L A L M Kiemeney  6   7 , C A Uyl-de Groot  3   4
Affiliations

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

S de Groot et al. Qual Life Res. 2018 Jan.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Cost-effectiveness analysis; EORTC QLQ-C30; EQ-5D; Health-related quality of life; Metastatic renal cell carcinoma; Targeted therapy.

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Conflict of interest statement

Conflict of interest

MV is a member of the EuroQoL research foundation. SS received speaker honoraria from GlaxoSmithKline. LK received an unrestricted research grant from Pfizer to extend the data collection of the PERCEPTION registry. CU received unrestricted research grants from Pfizer (formerly Wyeth Pharmaceuticals BV) and Roche Nederland BV to support the PERCEPTION registry. All remaining authors declared no conflict of interest.

Ethical approval

The research protocol was approved by the medical ethics committee of Radboud university medical center in Nijmegen (CMO Region Arnhem-Nijmegen) in May 2010.

Informed consent

Informed consent was obtained from all patients participating in the HRQoL study.

Figures

Fig. 1
Fig. 1
Proportion of patients reporting levels 1–5 by dimension, before progression of disease
Fig. 2
Fig. 2
Proportion of patients reporting levels 1–5 by dimension, after progression of disease
See this image and copyright information in PMC

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