Abstract Older adults with cancer often face decisions about prioritizing quality of life, survival, or both. In this prospective study of 181 patients aged ≥65 at a community cancer center, patients completed a geriatric assessment that included a validated trade-off question: “Maintaining my quality of life is more important to me than living longer.” Preferences were categorized as prioritizing quality of life, quantity of life, or both. Older age (OR 1.06; p = 0.04) and female sex (OR 2.82; p = 0.01) were associated with prioritizing quality of life. Functional, cognitive, or psychosocial impairments were not. Prioritizing quality of life was not associated with worse overall survival (HR 1.06; p = 0.89). Receipt of standard treatment improved survival (HR 0.38; p = 0.04), while ECOG 3–4 predicted worse outcomes. These findings challenge assumptions that prioritizing quality of life compromises survival and support the integration of geriatric assessment and values-based discussions into cancer care.
Aleixo et al. (Wed,) studied this question.