Malin Sternby Eilard1, Hannes Hagström2, Kim Erlend Mortensen3, Tom Wilsgaard4, Ola Magne Vagnildhaug5, Olav Dajani6, Per Stål2, Magnus Rizell1. 1. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 2. Unit of Hepatology, Department of Medicine, Center for Digestive Diseases, Karolinska Institute, Karolinska University Hospital, Huddinge, Stockholm, Sweden. 3. Department of Surgery, University Hospital North Norway, Tromsø, Norway. 4. Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway. 5. Department of Oncology, University Hospital of North Norway, Tromsø, Norway. 6. Department of Oncology, Oslo University Hospital, Oslo, Norway.
Abstract
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 HCC18, 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 HCC18 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 HCC18 increased the prognostic accuracy slightly.
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 HCC18, 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 HCC18 nutrition scale with selected background parameters. CONCLUSION: Quality-of-life questionnaires can prognosticate mortality in HCCpatients. When combined with established scoring systems, both the general cancer questionnaire EORTC QLQ C30, and the additional liver cancer-specific HCC18 increased the prognostic accuracy slightly.
Authors: Cyrill Wehling; Daniel Hornuss; Pasquale Schneider; Christoph Springfeld; Katrin Hoffmann; De-Hua Chang; Patrick Naumann; Markus Mieth; Thomas Longerich; Clemens Kratochwil; Arianeb Mehrabi; Annika Gauss; Karl Heinz Weiss; Jan Pfeiffenberger Journal: J Cancer Res Clin Oncol Date: 2019-08-19 Impact factor: 4.553
Authors: Leung Li; Stephen L Chan; Frankie Mo; Edwin P Hui; Jane Koh; Allen K C Chan; Nelson L S Tang; Kit F Lee; Paul B S Lai; Simon C H Yu; Winnie Yeo Journal: Cancer Manag Res Date: 2019-04-04 Impact factor: 3.989
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