Prognostic value of Quality of life (QoL) assessment among Tunisian lung cancer patients

Aim: To investigate the prognostic value of quality of life (QoL) assessment among Tunisian lung cancer patients for survival. Methods: A prospective cohort study was performed from January 2018 to June 2019. Performance status (PS), QoL questionnaire-core30 (QLQ-C30), QoL questionnaire-Lung Cancer 13 (QLQ-LC13) and European QoL-5 dimensions-3level version questionnaire (EQ-5D-3L) were used to QoL assessment. Patients were divided into 2 groups according to global QLQ-C30 score, a Clinically Significant Deficit (CSD) was considered if the score was ≤50. Cox regression analysis and Stepwise regression analysis were performed to evaluate the prognostic significance of QoL.Overall survival (OS) was calculated using the Kaplan-Meier method. Log-rank test was used to compare survival curves. p value cutoff for statistical significance was 0.05. Results: One hundred patients were included. Median OS for patients with CSD in QoL was 365 days, compared with 467 days for those without significant difference in QoL (Log-rank test, p=0.036). Similarly, Median progression free survival for patients with CSD in QoL was 122 days compared with 326 days for those who did not report a significant difference in QoL (Log-rank test, p=0.05). Upon multivariable stepwise regression analysis, Global QoL score (QLQ-C30) was a significant predictor of OS (coefficient estimate (CE)=0.336, p=0.005), along with stage IV (CE=-0.193, p=0.033) and tumor progression (CE =-0.238, p=0.047). Conclusion: QoL was a predictor of survival in our cohort of patients with lung cancer. This should recommend an active intervention for patients with a significant deficit in QoL in Early Palliative Care.