Wei-Chu Chie1, Fang Yu2, Mengqian Li3, Lorena Baccaglini4, Jane M Blazeby5, Chin-Fu Hsiao6, Herng-Chia Chiu7, Ronnie T Poon8, Naoko Mikoshiba9, Gillian Al-Kadhimi10, Nigel Heaton10, Jozer Calara10, Peter Collins11, Katharine Caddick11, Anna Costantini12, Valerie Vilgrain13,14, Chieh Chiang6. 1. Graduate Institute of Epidemiology and Preventive Medicine, Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan. 2. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. fangyu@unmc.edu. 3. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. 4. Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. 5. School of Social & Community Medicine, University of Bristol, Bristol, UK. 6. Division of Clinical Trial Statistics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan. 7. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan. 8. Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong. 9. Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 10. Institute of Liver Studies, King's College Hospital, London, UK. 11. Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK. 12. Psychooncology Unit, Sant'Andrea Hospital-Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. 13. Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, France. 14. Université Paris Diderot, Sorbonne Paris Cité, INSERM Centre de recherche Biomédicale Bichat Beaujon, CRB3 U773 75018, Paris, France.
Abstract
PURPOSE: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. One of the primary treatment goals for incurable advanced cases is to prolong quality of life (QoL). Thus, to determine which HCC therapies may be linked to a more favorable QoL, we assessed the association between QoL changes and different treatments in HCC patients. METHODS: We analyzed a non-randomized multicenter longitudinal study, which included 171 patients treated with surgery (n = 53), ablation (n = 53) or embolization (n = 65) from seven centers: four Asian and three European sites. All participants completed the EORTC QLQ-C30 and QLQ-HCC18 questionnaires before and after treatment. Propensity scores were calculated and used in addition to race for adjustment in the logistic regression model to account for the confounding effects of patient characteristics including age, gender, race, employment, living with family, at least one comorbid condition, years since diagnosis, prior treatment history, BCLC stage, Child-Pugh grade, cirrhosis, bilirubin levels and QoL score before treatment. RESULTS: After adjustment for confounders, patients tended to have higher odds of QoL deterioration when treated with ablation versus embolization (dyspnea: p = 0.019; appetite loss: p = 0.018; body image: p = 0.035) or ablation versus surgery (dyspnea: p = 0.099; appetite loss: p = 0.100; body image: p = 0.038). CONCLUSIONS: There were significant differences in QoL deterioration across different treatment groups. This information may assist patients and providers when selecting patient-centered treatment approaches for HCC.
PURPOSE:Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. One of the primary treatment goals for incurable advanced cases is to prolong quality of life (QoL). Thus, to determine which HCC therapies may be linked to a more favorable QoL, we assessed the association between QoL changes and different treatments in HCC patients. METHODS: We analyzed a non-randomized multicenter longitudinal study, which included 171 patients treated with surgery (n = 53), ablation (n = 53) or embolization (n = 65) from seven centers: four Asian and three European sites. All participants completed the EORTC QLQ-C30 and QLQ-HCC18 questionnaires before and after treatment. Propensity scores were calculated and used in addition to race for adjustment in the logistic regression model to account for the confounding effects of patient characteristics including age, gender, race, employment, living with family, at least one comorbid condition, years since diagnosis, prior treatment history, BCLC stage, Child-Pugh grade, cirrhosis, bilirubin levels and QoL score before treatment. RESULTS: After adjustment for confounders, patients tended to have higher odds of QoL deterioration when treated with ablation versus embolization (dyspnea: p = 0.019; appetite loss: p = 0.018; body image: p = 0.035) or ablation versus surgery (dyspnea: p = 0.099; appetite loss: p = 0.100; body image: p = 0.038). CONCLUSIONS: There were significant differences in QoL deterioration across different treatment groups. This information may assist patients and providers when selecting patient-centered treatment approaches for HCC.
Entities:
Keywords:
Asian; Carcinoma; Hepatocellular; Quality of life; Treatment
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