Health-Related Quality of Life in Adrenocortical Carcinoma: Development of the Disease-Specific Questionnaire ACC-QOL and Results from the PROFILES Registry

Rebecca V Steenaard*, Thomas M A Kerkhofs, Myrte Zijlstra, Floortje Mols, Michiel N Kerstens, Henry J L M Timmers, Rachel S van Leeuwaarde, Koen M A Dreijerink, Elisabeth M W Eekhoff, Els J M Nieveen van Dijkum, Eleonora P M Corssmit, Ellen Kapiteijn, Marjolein N T Kremers, Richard A Feelders, Harm R Haak

*Corresponding author for this work

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Abstract

We aimed to develop a disease-specific adrenocortical carcinoma (ACC) health-related quality of life (HRQoL) questionnaire (ACC-QOL) and assess HRQoL in a population-based cohort of patients with ACC. Development was in line with European Organization for Research and Treatment of Cancer (EORTC) guidelines, though not an EORTC product. In phase I and II, we identified 90 potential HRQoL issues using literature and focus groups, which were reduced to 39 by healthcare professionals. Pilot testing resulted in 28 questions, to be used alongside the EORTC QLQ-C30. In Phase III, 100 patients with ACC were asked to complete the questionnaires twice in the PROFILES registry (3-month interval, respondents: first 67, second 51). Confirmatory factor analysis demonstrated the structural validity of 26 questions with their scale structure (mitotane side-effects, hypercortisolism/hydrocortisone effects, emotional effects). Internal consistency and reliability were good (Cronbach's alpha 0.897, Interclass correlation coefficient 0.860). Responsiveness analysis showed good discriminative ability (AUC 0.788). Patients diagnosed more than 5 years ago reported a good HRQoL compared with the Dutch reference population, but experienced residual fatigue and emotional problems. Patients who underwent recent treatment reported a lower HRQoL and problems in several domains. In conclusion, we developed an ACC-specific HRQoL questionnaire with good psychometric properties.

Original languageEnglish
Article number1366
Number of pages11
JournalCancers
Volume14
Issue number6
DOIs
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
Funding: This research was funded in part by HRA Pharma, Paris, France.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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