Abstract
BACKGROUND: Three subgroups of adolescent and young adult patients (AYAs; 18-39 at diagnosis) with an uncertain or poor cancer prognosis (UPCP-those diagnosed with advanced disease, who will likely die prematurely) were previously identified: those receiving traditional treatments (chemotherapy and/or radiotherapy), newer treatments (immunotherapy or targeted therapy), and patients with glioma. This study examines differences in health-related quality of life (HRQoL) among these subgroups, and comparisons between AYAs with a UPCP, recently diagnosed AYAs, and a healthy control group. METHODS: Data were collected from two AYA cohorts: CORD-AYA (n = 155), including AYAs with a UPCP any moment post-diagnosis, and COMPRAYA (n = 549), including AYAs within 6 months after diagnosis. A healthy control group, matched by age and sex, was also included (n = 430). All completed the EORTC QLQ-C30. RESULTS: No significant HRQoL differences emerged between the traditional versus new treatment group. However, patients with glioma reported significantly lower cognitive functioning compared to patients on newer therapies. AYAs with a UPCP scored lower across all HRQoL scales than the control group. Despite being further along in their disease trajectory, UPCP patients reported HRQoL levels comparable to newly diagnosed patients. AYAs with a UPCP experienced higher financial burden but reported better global quality of life than COMPRAYA patients. CONCLUSIONS: No significant differences in HRQoL were found between treatment groups, but patients with glioma should be considered a distinct subgroup as they have shown reduced cognitive functioning, necessitating specialized care. Individualized care is crucial, as a lack of personalized support may lead to long-term functional impairment, especially among UPCP patients.