PROs are useful prognostic factors for cancer, study suggests

Written by Ilana Landau, Editor

The results of a new systematic review suggest that patient-reported outcomes (PROs) from individuals with cancer may function as important prognostic indicators of their disease progression.

A team of researchers, led by Andrew Bottomley of the European Organisation for Research and Treatment of Cancer (EORTC; Brussels, Belgium), has conducted a systematic review and meta-analysis of randomized controlled trials that measured caner patients’ self-reported quality-of-life scores. The results suggest that patient-reported outcomes (PROs) from individuals with cancer may function as considerably valuable prognostic indicators of their disease progression and survival rates.

In the study, investigators analyzed data from 44 Phase II or III clinical trials, carried out from 2006—2018, involving a total of 28,281 patients. This study population included patients with 13 different cancer types. Self-reported quality-of-life scores of a subset of 23,122 study participants were available for analysis. 

Across the randomized trials included in this study, researchers observed that the EORTC Quality of Life Core and Functional Assessment of Cancer Treatment questionnaires were the most routinely employed tools for recording PROs.

Researchers observed that, following controlling for various clinical variables, in 93% of cases at least one PRO measurement — such as physical functioning — was independently, significantly associated patients’ overall survival rates.

Bottomley stated: “This is an important result that, additionally, allowed us to confirm that methods and standards of collecting and analyzing [quality-of-life] data have improved…though we still need some methodological improvements if we are to optimize the prognostic value of these data.”

“We plan to do a further analysis in five years’ time to check that future studies have improved methods further, whether clinical triallists are using these results to stratify patients in trials, and the extent to which they are being used as prognostic indicators,” added Bottomley.

The study authors express their hopes that their research may encourage the consideration of patients’ self-reported quality of life scores as critical parameters for determining optimal ‘targeted’ treatment options that are in line with patients’ needs and concerns.


Mierzynska J, Piccinin C, Pe M et al. Prognostic value of patient-reported outcomes from international randomised clinical trials on cancer: a systematic review. Lancet Oncol. 20(12); PE685—E698; (2019);