Impact of Systemic Inflammation on Quality of Life in Advanced Cancer


Key Points

  • Increased systemic inflammation and poorer ECOG performance status were both associated with poorer patient-reported quality of life in patients with advanced cancer.
  • Global health–quality-of-life outcomes were worse with greater systemic inflammation independent of ECOG performance status.

In a study reported in the Journal of Clinical Oncology, Laird et al found that increased systemic inflammation was associated with poorer patient-reported quality of life independent of performance status.

Study Details

The study involved data from 2,520 adult patients in a biobank of patients with advanced cancer collected prospectively at a single time point from multiple European sites. The most common cancers were gastrointestinal (22.2%) and pulmonary (17.6%).

Quality of life was evaluated at a single time point using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire C-30 (EORTC QLQ-C30), performance status was assessed using Eastern Cooperative Oncology Group (ECOG) classification, and systemic inflammation was assessed using the modified Glasgow Prognostic Score (mGPS) combining C-reactive protein and albumin levels. Patients had median survival of 4.25 months (interquartile range = 1.36–12.9 months).

Associations With Quality of Life

Poorer ECOG performance status and poorer mGPS (increased systemic inflammation) were individually associated with worsening of all EORTC patient-reported outcome measures (both P < .001 for all outcome measures). EORTC global health outcomes were worse for increasing systemic inflammation independent of performance status (P < .001), with similar outcomes observed in the role, physical, and social subscales (all P < .001).

The investigators concluded: “Systemic inflammation was associated with quality-of-life parameters independent of [performance status] in patients with advanced cancer. Further investigation of these relationships in longitudinal studies and investigations of possible effects of attenuating systemic inflammation are now warranted.”

The study was supported by the Norwegian Research Council and the European Union’s 6th Framework.

Barry J. Laird, MD, of the University of Edinburgh, is the corresponding author of the Journal of Clinical Oncology article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.