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, A. A. Secord, S. Wolf, G. Samsa, B. Davidson, A. P. Abernethy, D. Cella, L. J. Havrilesky, R. A. Burger, B. J. Monk, C. A. Leath*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

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. 45.6 months, P = 0.001) and worse median PFS (12.5 vs. 13.1 months, 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. 8.6 months, P = 0.001; Q2-4: 16.7 vs. 11.1 months, P < 0.001) and median OS (Q1: 40.8 vs. 16 months, P < 0.001; Q2-4: 54.4 vs. 33.6 months, 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.

Original languageEnglish (US)
Pages (from-to)98-103
Number of pages6
JournalGynecologic oncology
Volume147
Issue number1
DOIs
StatePublished - Oct 2017

Keywords

  • FACT-O TOI
  • NRG Oncology/GOG
  • Ovarian cancer
  • Quality of life
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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