Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study

Luigi Lim; Abigirl Machingura; Mekdes Taye; Madeline Pe; Corneel Coens; Francesca Martinelli; Ahu Alanya; Stéphanie Antunes; Dongsheng Tu; Ethan Basch; Jolie Ringash; Yvonne Brandberg; Mogens Groenvold; Alexander Eggermont; Fatima Cardoso; Jan Van Meerbeeck; Michael Koller; Winette T A Van der Graaf; Martin J B Taphoorn; Johan A F Koekkoek; Jaap C Reijneveld; Riccardo Soffietti; Galina Velikova; Andrew Bottomley; Henning Flechtner; Jammbe Musoro

doi:10.1016/j.eclinm.2025.103153

Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study

Luigi Lim^*, Abigirl Machingura, Mekdes Taye, Madeline Pe, Corneel Coens, Francesca Martinelli, Ahu Alanya, Stéphanie Antunes, Dongsheng Tu, Ethan Basch, Jolie Ringash, Yvonne Brandberg, Mogens Groenvold, Alexander Eggermont, Fatima Cardoso, Jan Van Meerbeeck, Michael Koller, Winette T A Van der Graaf, Martin J B Taphoorn, Johan A F KoekkoekJaap C Reijneveld, Riccardo Soffietti, Galina Velikova, Andrew Bottomley, Henning Flechtner, Jammbe Musoro,

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: A pooled data analysis by Quinten et al. (2009) found three European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) health-related quality of life (HRQoL) scales to be prognostic for survival: physical functioning, pain and appetite loss. This study aims to replicate these findings in an independent data set comprising a broader cancer population.

METHODS: Data were obtained from 46 clinical trials across three cancer research networks conducted between 1996 and 2013 that assessed HRQoL using the EORTC QLQ-C30. A stratified Cox proportional hazards model was employed to assess the prognostic significance of baseline QLQ-C30 scale scores on overall survival, adjusting for socio-demographic and clinical variables. Stepwise model selection was done at 5% significance level. Model stability and prognostic accuracy were evaluated via bootstrapping and the C index respectively.

FINDINGS: Data from 16,210 patients reporting HRQoL at baseline, spanning 17 cancer types, was used. The stratified multivariable model confirmed that better physical functioning (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.93-0.96), lower pain (HR, 1.02; 95% CI, 1.01-1.03), and appetite loss (HR, 1.04; 95% CI, 1.03-1.05) were significantly associated with survival. Additionally, global health status/QoL, dyspnoea, emotional and cognitive functioning were found to be prognostic for survival. This final model, encompassing sociodemographic, clinical, and HRQoL variables, achieved a corrected C index of 0.74, marking a 48% enhancement in discriminatory ability. Bootstrap evaluation indicated no major instability issues.

INTERPRETATION: These results support previous findings that baseline physical functioning, pain, and appetite loss scores, along with four other scales from the EORTC QLQ-C30, predict survival in cancer patients.

FUNDING: EORTC Quality of Life Group.

Original language	English
Article number	103153
Number of pages	11
Journal	EClinicalMedicine
Volume	82
DOIs	https://doi.org/10.1016/j.eclinm.2025.103153
Publication status	Published - Apr 2025
Externally published	Yes

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Lim, L., Machingura, A., Taye, M., Pe, M., Coens, C., Martinelli, F., Alanya, A., Antunes, S., Tu, D., Basch, E., Ringash, J., Brandberg, Y., Groenvold, M., Eggermont, A., Cardoso, F., Van Meerbeeck, J., Koller, M., Van der Graaf, W. T. A., Taphoorn, M. J. B. (2025). Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study. EClinicalMedicine, 82, Article 103153. https://doi.org/10.1016/j.eclinm.2025.103153

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title = "Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study",

abstract = "BACKGROUND: A pooled data analysis by Quinten et al. (2009) found three European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) health-related quality of life (HRQoL) scales to be prognostic for survival: physical functioning, pain and appetite loss. This study aims to replicate these findings in an independent data set comprising a broader cancer population.METHODS: Data were obtained from 46 clinical trials across three cancer research networks conducted between 1996 and 2013 that assessed HRQoL using the EORTC QLQ-C30. A stratified Cox proportional hazards model was employed to assess the prognostic significance of baseline QLQ-C30 scale scores on overall survival, adjusting for socio-demographic and clinical variables. Stepwise model selection was done at 5% significance level. Model stability and prognostic accuracy were evaluated via bootstrapping and the C index respectively.FINDINGS: Data from 16,210 patients reporting HRQoL at baseline, spanning 17 cancer types, was used. The stratified multivariable model confirmed that better physical functioning (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.93-0.96), lower pain (HR, 1.02; 95% CI, 1.01-1.03), and appetite loss (HR, 1.04; 95% CI, 1.03-1.05) were significantly associated with survival. Additionally, global health status/QoL, dyspnoea, emotional and cognitive functioning were found to be prognostic for survival. This final model, encompassing sociodemographic, clinical, and HRQoL variables, achieved a corrected C index of 0.74, marking a 48% enhancement in discriminatory ability. Bootstrap evaluation indicated no major instability issues.INTERPRETATION: These results support previous findings that baseline physical functioning, pain, and appetite loss scores, along with four other scales from the EORTC QLQ-C30, predict survival in cancer patients.FUNDING: EORTC Quality of Life Group.",

author = "Luigi Lim and Abigirl Machingura and Mekdes Taye and Madeline Pe and Corneel Coens and Francesca Martinelli and Ahu Alanya and St{\'e}phanie Antunes and Dongsheng Tu and Ethan Basch and Jolie Ringash and Yvonne Brandberg and Mogens Groenvold and Alexander Eggermont and Fatima Cardoso and {Van Meerbeeck}, Jan and Michael Koller and {Van der Graaf}, {Winette T A} and Taphoorn, {Martin J B} and Koekkoek, {Johan A F} and Reijneveld, {Jaap C} and Riccardo Soffietti and Galina Velikova and Andrew Bottomley and Henning Flechtner and Jammbe Musoro",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = apr,

doi = "10.1016/j.eclinm.2025.103153",

language = "English",

volume = "82",

}

Lim, L, Machingura, A, Taye, M, Pe, M, Coens, C, Martinelli, F, Alanya, A, Antunes, S, Tu, D, Basch, E, Ringash, J, Brandberg, Y, Groenvold, M, Eggermont, A, Cardoso, F, Van Meerbeeck, J, Koller, M, Van der Graaf, WTA, Taphoorn, MJB, Koekkoek, JAF, Reijneveld, JC, Soffietti, R, Velikova, G, Bottomley, A, Flechtner, H, Musoro, J 2025, 'Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study', EClinicalMedicine, vol. 82, 103153. https://doi.org/10.1016/j.eclinm.2025.103153

TY - JOUR

T1 - Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types

T2 - a validation study

AU - Lim, Luigi

AU - Machingura, Abigirl

AU - Taye, Mekdes

AU - Pe, Madeline

AU - Coens, Corneel

AU - Martinelli, Francesca

AU - Alanya, Ahu

AU - Antunes, Stéphanie

AU - Tu, Dongsheng

AU - Basch, Ethan

AU - Ringash, Jolie

AU - Brandberg, Yvonne

AU - Groenvold, Mogens

AU - Eggermont, Alexander

AU - Cardoso, Fatima

AU - Van Meerbeeck, Jan

AU - Koller, Michael

AU - Van der Graaf, Winette T A

AU - Taphoorn, Martin J B

AU - Koekkoek, Johan A F

AU - Reijneveld, Jaap C

AU - Soffietti, Riccardo

AU - Velikova, Galina

AU - Bottomley, Andrew

AU - Flechtner, Henning

AU - Musoro, Jammbe

PY - 2025/4

Y1 - 2025/4

N2 - BACKGROUND: A pooled data analysis by Quinten et al. (2009) found three European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) health-related quality of life (HRQoL) scales to be prognostic for survival: physical functioning, pain and appetite loss. This study aims to replicate these findings in an independent data set comprising a broader cancer population.METHODS: Data were obtained from 46 clinical trials across three cancer research networks conducted between 1996 and 2013 that assessed HRQoL using the EORTC QLQ-C30. A stratified Cox proportional hazards model was employed to assess the prognostic significance of baseline QLQ-C30 scale scores on overall survival, adjusting for socio-demographic and clinical variables. Stepwise model selection was done at 5% significance level. Model stability and prognostic accuracy were evaluated via bootstrapping and the C index respectively.FINDINGS: Data from 16,210 patients reporting HRQoL at baseline, spanning 17 cancer types, was used. The stratified multivariable model confirmed that better physical functioning (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.93-0.96), lower pain (HR, 1.02; 95% CI, 1.01-1.03), and appetite loss (HR, 1.04; 95% CI, 1.03-1.05) were significantly associated with survival. Additionally, global health status/QoL, dyspnoea, emotional and cognitive functioning were found to be prognostic for survival. This final model, encompassing sociodemographic, clinical, and HRQoL variables, achieved a corrected C index of 0.74, marking a 48% enhancement in discriminatory ability. Bootstrap evaluation indicated no major instability issues.INTERPRETATION: These results support previous findings that baseline physical functioning, pain, and appetite loss scores, along with four other scales from the EORTC QLQ-C30, predict survival in cancer patients.FUNDING: EORTC Quality of Life Group.

AB - BACKGROUND: A pooled data analysis by Quinten et al. (2009) found three European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) health-related quality of life (HRQoL) scales to be prognostic for survival: physical functioning, pain and appetite loss. This study aims to replicate these findings in an independent data set comprising a broader cancer population.METHODS: Data were obtained from 46 clinical trials across three cancer research networks conducted between 1996 and 2013 that assessed HRQoL using the EORTC QLQ-C30. A stratified Cox proportional hazards model was employed to assess the prognostic significance of baseline QLQ-C30 scale scores on overall survival, adjusting for socio-demographic and clinical variables. Stepwise model selection was done at 5% significance level. Model stability and prognostic accuracy were evaluated via bootstrapping and the C index respectively.FINDINGS: Data from 16,210 patients reporting HRQoL at baseline, spanning 17 cancer types, was used. The stratified multivariable model confirmed that better physical functioning (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.93-0.96), lower pain (HR, 1.02; 95% CI, 1.01-1.03), and appetite loss (HR, 1.04; 95% CI, 1.03-1.05) were significantly associated with survival. Additionally, global health status/QoL, dyspnoea, emotional and cognitive functioning were found to be prognostic for survival. This final model, encompassing sociodemographic, clinical, and HRQoL variables, achieved a corrected C index of 0.74, marking a 48% enhancement in discriminatory ability. Bootstrap evaluation indicated no major instability issues.INTERPRETATION: These results support previous findings that baseline physical functioning, pain, and appetite loss scores, along with four other scales from the EORTC QLQ-C30, predict survival in cancer patients.FUNDING: EORTC Quality of Life Group.

U2 - 10.1016/j.eclinm.2025.103153

DO - 10.1016/j.eclinm.2025.103153

M3 - Article

C2 - 40201799

SN - 2589-5370

VL - 82

JO - EClinicalMedicine

JF - EClinicalMedicine

M1 - 103153

ER -

Prognostic value of baseline EORTC QLQ-C30 scores for overall survival across 46 clinical trials covering 17 cancer types: a validation study

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