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Area of Science:

  • Oncology
  • Clinical Epidemiology
  • Health Outcomes Research

Background:

  • Patient-reported outcomes (PROs) assess patient health directly, including symptoms and quality of life.
  • While PROs are linked to survival, specific domain prognostic significance requires quantification.

Purpose of the Study:

  • To systematically review and meta-analyze randomized clinical trials (RCTs).
  • To evaluate baseline PROs' association with overall survival (OS) in cancer patients.
  • To quantify the prognostic significance of various PRO domains.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Cochrane Library (2000-2024).
  • Included prospective RCTs of adult cancer patients with baseline PROs and OS data.
  • Meta-analysis of 31 RCTs (44,030 patients) using random-effects models.

Main Results:

  • Higher quality of life/global health status correlated with improved OS (HR 0.99).
  • Physical and role functioning positively impacted OS (HRs 0.94 and 0.96).
  • Increased symptom burden (nausea, fatigue, pain) predicted worse OS (HRs >1.0).

Conclusions:

  • PROs offer independent prognostic value for cancer survival.
  • Findings support integrating PRO assessments into clinical decision-making.
  • PRO data can enhance risk stratification in oncology care.