Does baseline quality of life predict mortality in colorectal cancer?

Quality of life (QOL) predicts mortality in various cancers. While studies have examined this association in metastatic colorectal cancer (CRC) patients, associations between baseline QOL and long-term mortality in the broader CRC population remains underexplored. This exploratory study aimed to examine this association in CRC patients.
A prospective cohort of incident CRC patients were recruited from two public hospitals in Singapore and followed up until March 2025 or death. QOL was assessed at diagnosis using the global health status and five functional QOL domains (Physical, Role, Emotional, Cognitive, Social) of the EORTC QLQ-C30 instrument. Mortality and other baseline characteristics were extracted from institutional electronic medical records.
121 patients were recruited, 27 (22.31%) of whom died during the study. Bivariate analysis revealed significant associations between mortality and cancer stage (x^2=7.25, p<0.05), pre-surgical health status (measured by American Society of Anaesthesiology grading; x^2=5.82, p<0.05), and follow-up duration (z=6.512, p<0.001). However, multivariable logistic regression adjusting for these covariates revealed no significant association between baseline QOL and mortality.
Our preliminary findings did not suggest an association between QOL and mortality, suggesting that QOL may only predict mortality in late-stage metastatic disease. Clinicians should consider prioritising other factors, such as pre-existing conditions, in mortality risk-assessment. Further research is needed to validate these findings and explore underlying mechanisms, if any, given our relatively small sample size.