Health-related Quality of Life in Localized and Metastatic Renal Cell Carcinoma: Insights from Patient-reported Outcome Measures

TL;DR

Patients with kidney cancer show improved quality of life 15 weeks after diagnosis, with possible further improvements at six months.

Contribution

This study provides new insights into HRQoL changes in localized and metastatic RCC patients using PROMs over time.

Findings

Both M0 and mRCC patients showed significant improvements in emotional functioning within 15 weeks.

Patients reported reduced fatigue, pain, insomnia, and appetite loss after treatment initiation.

Improvements suggest the need for continued HRQoL monitoring beyond the early postdiagnosis period.

Abstract

Early and ongoing quality-of-life monitoring is crucial for patients with renal cell carcinoma. Improvements in emotional, social, and physical wellbeing are observed at 15 wk after diagnosis, with exploratory analyses suggesting potential further changes 6 mo after diagnosis. These findings highlight the need for tailored support and continued research beyond the early postdiagnosis period.

Patient-reported outcome measures (PROMs) are increasingly being used to evaluate health-related quality of life (HRQoL) in cancer care. We investigated the effects of treatment for both localized (M0) and metastatic renal cell carcinoma (mRCC) on generic and cancer-specific HRQoL up to 15 wk after diagnosis.

Patients were selected from the National PROspective infrastructure for renal cell carcinoma (PRO-RCC), including M0 and mRCC patients who participated in the HRQoL assessment. HRQoL was measured using the Dutch validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at baseline (T0), 15 wk (T1), and 6 mo (T2) after diagnosis. Within-group HRQoL changes over time were analyzed using paired t tests for patients with data available at multiple time points (T0 vs T1). Exploratory analyses comparing T0 versus T2 were also performed.

A total of 295 patients were included, of whom 217 (73.6%) had M0 disease and 78 (26.4%) had mRCC. At follow-up, 89 patients with M0 disease (41%) and 38 with mRCC (48.7%) completed the T1 assessment. In the M0 group, significant improvements at T1 were observed in scores for emotional functioning (80.2 vs 87.4; change [Δ] 7.2, 95% confidence interval [CI] 3.8–10.5; p < 0.001), social functioning (81.8 vs 86.7; Δ 4.9, 95% CI 0.2–9.6, p = 0.042), insomnia (31.5 vs 22.9; Δ −8.6, 95% CI −13.9 to −3.4; p = 0.002), and appetite loss (11.6 vs 6.4; Δ −5.2, 95% CI −9.3 to −1.2; p = 0.012). In the mRCC group, significant improvements at T1 were noted in scores for emotional functioning (77.9 vs 84.7; Δ 6.8, 95% CI −1.4 to 14.9; p = 0.015), fatigue (31.6 vs 23.7; Δ −7.9, 95% CI −15.5 to −0.3; p = 0.042), and pain (18.4 vs 7.5; Δ −10.9, 95% CI −19.8 to −2.1; p = 0.017).

Patients with M0 disease and mRCC experienced improvements in several functional and symptom domains within 15 wk after diagnosis. Future studies should assess the impact of these changes on treatment continuation and/or responses.

We looked at health-related quality of life (HRQoL) in patients with localized or metastatic kidney cancer. In general, both groups reported improvements in emotional, social, and physical wellbeing at 15 weeks after their diagnosis, and results suggest further changes at 6 months after diagnosis. Patients reported improvements in symptoms such as fatigue, pain, sleep, and appetite. Our results indicate that patients can find meaningful improvements in their quality of life shortly after diagnosis and initiation of treatment.

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