e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Prognostic value of patient reported outcomes in advanced gastro-oesophageal cancer: a systematic review (#337)

Sayeda SKN Naher 1 , Ho HS Siu 2 , Peter PG Grimison 3 , Martin MS Stockler 4 , Rebecca RB Mercieca-Bebber 5
  1. Oncology, NHMRC Clinical Trials Centre, the University of Sydney, NSW, Australia., Camperdown , NSW, Australia
  2. Oncology, NHMRC Clinical Trials Centre, the University of Sydney, NSW, Australia., Camperdown , NSW, Australia
  3. Oncology, Chris O'Brien Lifehouse, Camperdown , NSW, Australia
  4. Oncology, NHMRC Clinical Trials Centre, the University of Sydney, NSW, Australia., Camperdown , NSW, Australia
  5. Oncology, NHMRC Clinical Trials Centre, the University of Sydney, NSW, Australia., Camperdown, NSW, Australia

Aim

To summarise the prognostic value of patient-reported outcomes (PROs) in advanced gastro-oesophageal (GO) cancer.

Methods

We systematically searched multiple databases using search terms developed with medical librarians. Studies examining the relationship between baseline PROs and prognosis were included. Two reviewers screened articles and extracted data on study design, survival and univariable and multivariable relationships between PROs and prognosis. QUAL-SYST was used for quality assessment. Discrepancies were resolved by a third reviewer.

Results

Of 3002 abstracts, seven studies were included: four pooled analyses of randomised controlled trials (RCTs), two RCTs and one cohort study. Five received QUAL-SYST scores >65%. Median survival ranged from 4.5 to 9.5 months.

In one univariable analysis for oesophageal squamous cell cancer (SCC), physical functioning and fatigue measured by QLQ-C30 had prognostic significance. For adenocarcinoma, physical functioning, global QOL, role functioning, emotional functioning (QLQ-C30) were significant in three studies.  Pain was significant in three studies (QLQ-C30 n=2, EQ-5D-3L n=1). Fatigue (QLQ-C30) was significant in two studies. Appetite loss (QLQ-C30) was significant in two studies.

In multivariable analyses for oesophageal SCC (QLQ-C30) physical and social functioning had prognostic significance. In adenocarcinoma, physical functioning, role functioning, appetite loss showed prognostic significance in two studies, global QOL, social functioning, pain and constipation in one study, all used QLQ-C30. Low levels of abdominal pain (QLQ-STO22) correlated with better survival in one study. Higher EQ-5D-3L score had better prognosis in two studies. One study showed adenocarcinoma patients with lower anorexia (higher FAACT-A/CS scores of >37) lived longer (19.3 months) than patients with low scores ≤37 (6.7 months).

 

Conclusions

 Baseline PRO scores for multiple functional domains, symptoms (pain, appetite loss) and overall QOL have prognostic significance. Further research is needed to establish clear levels of the relationship which could assist in communication with patients about prognosis, and stratification for clinical trials.