Baseline functioning scales of quality of life (EORTC QLQ-C30) as a predictor of overall survival in patients with lung cancer: a meta-analysis.

Background: Studies have shown inconsistent associations between quality of life (QoL) and survival in patients with lung cancer (LC).

Objective: To assess the association between baseline functioning scales from the EORTC QoL Questionnaire Core 30 (QLQ-C30) and overall survival in patients with LC by conducting a meta-analysis.

Methods: Two independent authors searched PubMed and Embase databases using the following PECOS criteria: population (patients with pathological diagnosis of LC), exposure (poor health-related QoL, as measured by the functioning scales of EORTC QLQ-C30), comparator (better QoL), outcomes (overall survival), and study design (cohort studies).

Results: Sixteen studies with 9429 patients were identified. Compared to the highest scores, the lowest scores on the global QoL (hazard ratios [HR] 1.59; 95% confidence intervals [CI] 1.38-1.84), physical functioning (HR 1.58; 95% CI 1.24-2.03), role functioning (HR 1.43; 95% CI 1.19-1.73), and emotional functioning (HR 1.29; 95% CI 1.05-1.60) scales significantly predicted poorer overall survival. A 10-point increase in the global QoL, physical functioning, and role functioning scales was associated with a reduced risk of mortality (HR 0.87; 95% CI 0.84-0.91, HR 0.88; 95% CI 0.85-0.92, and HR 0.93; 95% CI 0.87-0.99, respectively). However, 10-point increases in the emotional functioning (HR 0.97; 95% CI 0.92-1.01), cognitive functioning (HR 0.97; 95% CI 0.95-1.00), and social functioning (HR 0.95; 95% CI 0.90-1.01) scales did not significantly predict overall survival.

Conclusions: Baseline QoL, specifically lower scores on the global QoL, physical functioning, and role functioning scales of the EORTC QLQ-C30, significantly predicts poorer overall survival in patients with LC.