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Quality of life as a prognostic factor for survival in hepatocellular carcinoma
Author(s) -
Sternby Eilard Malin,
Hagström Hannes,
Mortensen Kim Erlend,
Wilsgaard Tom,
Vagnildhaug Ola Magne,
Dajani Olav,
Stål Per,
Rizell Magnus
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13593
Subject(s) - medicine , hepatocellular carcinoma , quality of life (healthcare) , proportional hazards model , liver cancer , multivariate analysis , oncology , multivariate statistics , cancer , performance status , statistics , nursing , mathematics
Background & Aims Prognostication in hepatocellular carcinoma ( HCC ) is demanding. Not only tumour extent and performance status are to be considered, but also liver function, which is often limiting for both survival itself and for treatment possibilities. This study was conducted to assess whether patient‐reported questionnaires containing general and liver‐specific questions could improve prognostication of survival. Methods 185 patients with hepatocellular carcinoma in Norway and Sweden were prospectively included. Patients completed the quality‐of‐life questionnaires EORTC QLQ C30 and HCC 18, and clinical, radiological and laboratory parameters were registered. Multivariate Cox regression and Harrell's C‐statistics were used to identify the model that best predicted mortality. Results Quality‐of‐life data were prognostic for overall survival. Fatigue and nutrition scales were prognostic in the multivariable analyses alone and in combination with clinical parameters. The prognostic value of established scoring systems was increased by the addition of QoL data. The best prognostic power was achieved by combining HCC 18 nutrition scale with selected background parameters. Conclusion Quality‐of‐life questionnaires can prognosticate mortality in HCC patients. When combined with established scoring systems, both the general cancer questionnaire EORTC QLQ C30, and the additional liver cancer‐specific HCC 18 increased the prognostic accuracy slightly.