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Peer-reviewedCC BY 4.0Journal of Cancer Survivorship

Trajectories of patient-reported outcomes among diverse cancer patients in ambulatory oncology clinics

  • Akina Natori1,2
  • Blanca Silvia Noriega Esquives2
  • Vandana D. Sookdeo2
  • Rui Gong1
  • Jessica MacIntyre2
  • Patricia I. Moreno3
  • Carmen Calfa1,2
  • Tracy E. Crane1,2
  • Matthew Schlumbrecht2,4
  • Frank J. Penedo2,5,6
6 affiliations
  1. 1Division of Medical Oncology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL USA
  2. 2Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
  3. 3Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL USA
  4. 4Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL USA
  5. 5Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14 Street, Miami, FL 33136 USA
  6. 6Department of Psychology, University of Miami, Coral Gables, USA
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Abstract

Purpose: Tracking patient-reported outcomes (PROs) offers critical insights into cancer survivors’ symptoms and health-related quality of life (HRQOL). This study evaluated longitudinal trajectories of PROs across cancer types and identified factors associated with symptom burden and HRQOL.

Methods: We conducted a retrospective longitudinal observational study of 6939 cancer survivors (breast, prostate, lung, head and neck (H&N), gastrointestinal (GI), gynecological (GYN), and hematological malignancies) in ambulatory oncology clinics. All cancer survivors completed electronic health record–integrated PRO assessments measuring anxiety, depression, pain interference, fatigue, and physical function, and HRQOL. Linear mixed-effect models evaluated difference in PRO level and change over time by cancer types, adjusting for sociodemographic and clinical covariates.

Results: Meaningful differences in overall symptom burden were observed across cancer types. Survivors with GYN cancers reported consistently higher anxiety, pain interference, fatigue, and poorer physical function, whereas prostate cancer survivors reported lowest symptom burden and highest HRQOL. Hematologic malignancy survivors improved in physical function over time compared to prostate cancer survivors. Chemotherapy and surgery were associated with greater pain interference, fatigue, reduced physical function, and lower HRQOL. Greater comorbidity burden and being unpartnered were associated with worse PRO.

Conclusions: PRO trajectories varied by cancer types and patient characteristics, underscoring the need for tailored, cancer-specific survivorship care strategies.

Implications for Cancer Survivors: Routine, EHR-integrated PRO monitoring can identify survivors at risk for persistent symptom burden and support timely, individualized interventions to improve long-term HRQOL.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02050-0.

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Cite

BibTeXRIS
BibTeX
@article{natori2026trajectories,
  title = {{Trajectories of patient-reported outcomes among diverse cancer patients in ambulatory oncology clinics}},
  author = {Akina Natori and Blanca Silvia Noriega Esquives and Vandana D. Sookdeo and Rui Gong and Jessica MacIntyre and Patricia I. Moreno and Carmen Calfa and Tracy E. Crane and Matthew Schlumbrecht and Frank J. Penedo},
  journal = {Journal of Cancer Survivorship},
  year = {2026},
  month = jun,
  doi = {10.1007/s11764-026-02050-0},
  url = {https://doi.org/10.1007/s11764-026-02050-0},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Trajectories of patient-reported outcomes among diverse cancer patients in ambulatory oncology clinics
AU  - Akina Natori
AU  - Blanca Silvia Noriega Esquives
AU  - Vandana D. Sookdeo
AU  - Rui Gong
AU  - Jessica MacIntyre
AU  - Patricia I. Moreno
AU  - Carmen Calfa
AU  - Tracy E. Crane
AU  - Matthew Schlumbrecht
AU  - Frank J. Penedo
PY  - 2026
DA  - 2026/06/04
JO  - Journal of Cancer Survivorship
DO  - 10.1007/s11764-026-02050-0
UR  - https://doi.org/10.1007/s11764-026-02050-0
AB  - Purpose: Tracking patient-reported outcomes (PROs) offers critical insights into cancer survivors’ symptoms and health-related quality of life (HRQOL). This study evaluated longitudinal trajectories of PROs across cancer types and identified factors associated with symptom burden and HRQOL.  Methods: We conducted a retrospective longitudinal observational study of 6939 cancer survivors (breast, prostate, lung, head and neck (H&N), gastrointestinal (GI), gynecological (GYN), and hematological malignancies) in ambulatory oncology clinics. All cancer survivors completed electronic health record–integrated PRO assessments measuring anxiety, depression, pain interference, fatigue, and physical function, and HRQOL. Linear mixed-effect models evaluated difference in PRO level and change over time by cancer types, adjusting for sociodemographic and clinical covariates.  Results: Meaningful differences in overall symptom burden were observed across cancer types. Survivors with GYN cancers reported consistently higher anxiety, pain interference, fatigue, and poorer physical function, whereas prostate cancer survivors reported lowest symptom burden and highest HRQOL. Hematologic malignancy survivors improved in physical function over time compared to prostate cancer survivors. Chemotherapy and surgery were associated with greater pain interference, fatigue, reduced physical function, and lower HRQOL. Greater comorbidity burden and being unpartnered were associated with worse PRO.  Conclusions: PRO trajectories varied by cancer types and patient characteristics, underscoring the need for tailored, cancer-specific survivorship care strategies.  Implications for Cancer Survivors: Routine, EHR-integrated PRO monitoring can identify survivors at risk for persistent symptom burden and support timely, individualized interventions to improve long-term HRQOL.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02050-0.
SN  - 1932-2259
SN  - 1932-2267
ER  -