This thesis
aimed to identify prognostic and predictive factors for overall survival and to
explore the health-related quality of life (HRQoL) in patients with
oesophagogastric cancer.
Several
clinically relevant prognostic and predictive factors associated with systemic
therapy in advanced oesophagogastric cancer were identified, supporting
personalized treatment and future trial design.
Our review
of palliative systemic therapy showed that, although baseline HRQoL is
generally impaired, most therapies help maintain HRQoL, with some therapies offering
better outcomes than others. However, HRQoL reporting in randomized trials
remains limited and variable, with minimal improvement over time.
This thesis
also presents the POCOP project (Prospective Observational Cohort study of Oesophagogastric
cancer Patients) and its
collaboration with other Dutch cancer cohorts, providing a foundation for
large-scale research and innovative study designs.
Furthermore,
external validation of the Dutch SOURCE survival prediction models using
Belgian cancer registry data showed good calibration in gastric cancer but poor
calibration in oesophageal cancer, emphasizing the need for validation before
clinical application.
The last study
of this thesis confirmed that HRQoL is an independent prognostic factor in both
curative and palliative settings, indicating that HRQoL scales could be used to
develop or update prognostic models.
The thesis
concludes by highlighting the value of combining clinical trial and real-world
data to improve outcomes of oesophagogastric cancer patients. It stresses the
need for better HRQoL reporting and the use of patient-reported outcomes to
support informed, personalized treatment decision making.
