Role functioning is associated with survival in patients with hepatocellular carcinoma

Adam Meier, Adam Yopp, Huram Mok, Pragathi Kandunoori, Jasmin Tiro, Amit G. Singal

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Prior studies assessing quality of life (QOL) in patients with hepatocellular carcinoma (HCC) primarily included patients with preserved liver function and/or early HCC, leading to overestimation of QOL. Our study’s aim was to evaluate the association of QOL with survival among a cohort of cirrhotic patients with HCC that was diverse with respect to liver function and tumor stage. Methods: We conducted a prospective cohort study among cirrhotic patients with HCC from a large urban safety-net hospital between April 2011 and September 2013. Patients completed two self-administered surveys, the EORTC QLQ-C30 and QLQ-HCC18, prior to the treatment. We used generalized linear models to identify correlates of QOL. Survival curves were generated using Kaplan–Meier analysis and compared using log rank test to determine whether QOL is associated with survival. Results: A total of 130 treatment-naïve patients completed both surveys. Patients reported high cognitive and social function (median scores 67) but poor global QOL (median score 50) and poor role function (median score 50). QOL was associated with cirrhosis-related (p = 0.02) and tumor-related (p = 0.02) components of Barcelona Clinic Liver Cancer (BCLC) tumor stage. QOL was associated with survival on univariate analysis (HR 0.37, 95 % CI 0.16–0.85) but became nonsignificant (HR 0.82, 95 % CI 0.37–1.80) after adjusting for BCLC stage and treatment. Role functioning was significantly associated with survival (HR 0.40, 95 % CI 0.20–0.81), after adjusting for Caucasian race (HR 0.31, 95 % CI 0.16–0.59), BCLC stage (HR 1.51, 95 % CI 0.21–1.89), and treatment (HR 0.57, 95 % CI 0.33–0.97). Conclusions: Role function has prognostic significance and is important to assess in patients with HCC.

Original languageEnglish (US)
Pages (from-to)1669-1675
Number of pages7
JournalQuality of Life Research
Volume24
Issue number7
DOIs
StatePublished - Dec 13 2014

Fingerprint

Hepatocellular Carcinoma
Quality of Life
Survival
Liver Neoplasms
Safety-net Providers
Neoplasms
Liver
Therapeutics
Cognition
Linear Models
Fibrosis
Cohort Studies
Prospective Studies

Keywords

  • Liver cancer
  • Prognosis
  • Quality of life
  • Role function

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Role functioning is associated with survival in patients with hepatocellular carcinoma. / Meier, Adam; Yopp, Adam; Mok, Huram; Kandunoori, Pragathi; Tiro, Jasmin; Singal, Amit G.

In: Quality of Life Research, Vol. 24, No. 7, 13.12.2014, p. 1669-1675.

Research output: Contribution to journalArticle

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abstract = "Background: Prior studies assessing quality of life (QOL) in patients with hepatocellular carcinoma (HCC) primarily included patients with preserved liver function and/or early HCC, leading to overestimation of QOL. Our study’s aim was to evaluate the association of QOL with survival among a cohort of cirrhotic patients with HCC that was diverse with respect to liver function and tumor stage. Methods: We conducted a prospective cohort study among cirrhotic patients with HCC from a large urban safety-net hospital between April 2011 and September 2013. Patients completed two self-administered surveys, the EORTC QLQ-C30 and QLQ-HCC18, prior to the treatment. We used generalized linear models to identify correlates of QOL. Survival curves were generated using Kaplan–Meier analysis and compared using log rank test to determine whether QOL is associated with survival. Results: A total of 130 treatment-na{\"i}ve patients completed both surveys. Patients reported high cognitive and social function (median scores 67) but poor global QOL (median score 50) and poor role function (median score 50). QOL was associated with cirrhosis-related (p = 0.02) and tumor-related (p = 0.02) components of Barcelona Clinic Liver Cancer (BCLC) tumor stage. QOL was associated with survival on univariate analysis (HR 0.37, 95 {\%} CI 0.16–0.85) but became nonsignificant (HR 0.82, 95 {\%} CI 0.37–1.80) after adjusting for BCLC stage and treatment. Role functioning was significantly associated with survival (HR 0.40, 95 {\%} CI 0.20–0.81), after adjusting for Caucasian race (HR 0.31, 95 {\%} CI 0.16–0.59), BCLC stage (HR 1.51, 95 {\%} CI 0.21–1.89), and treatment (HR 0.57, 95 {\%} CI 0.33–0.97). Conclusions: Role function has prognostic significance and is important to assess in patients with HCC.",
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AU - Meier, Adam

AU - Yopp, Adam

AU - Mok, Huram

AU - Kandunoori, Pragathi

AU - Tiro, Jasmin

AU - Singal, Amit G.

PY - 2014/12/13

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N2 - Background: Prior studies assessing quality of life (QOL) in patients with hepatocellular carcinoma (HCC) primarily included patients with preserved liver function and/or early HCC, leading to overestimation of QOL. Our study’s aim was to evaluate the association of QOL with survival among a cohort of cirrhotic patients with HCC that was diverse with respect to liver function and tumor stage. Methods: We conducted a prospective cohort study among cirrhotic patients with HCC from a large urban safety-net hospital between April 2011 and September 2013. Patients completed two self-administered surveys, the EORTC QLQ-C30 and QLQ-HCC18, prior to the treatment. We used generalized linear models to identify correlates of QOL. Survival curves were generated using Kaplan–Meier analysis and compared using log rank test to determine whether QOL is associated with survival. Results: A total of 130 treatment-naïve patients completed both surveys. Patients reported high cognitive and social function (median scores 67) but poor global QOL (median score 50) and poor role function (median score 50). QOL was associated with cirrhosis-related (p = 0.02) and tumor-related (p = 0.02) components of Barcelona Clinic Liver Cancer (BCLC) tumor stage. QOL was associated with survival on univariate analysis (HR 0.37, 95 % CI 0.16–0.85) but became nonsignificant (HR 0.82, 95 % CI 0.37–1.80) after adjusting for BCLC stage and treatment. Role functioning was significantly associated with survival (HR 0.40, 95 % CI 0.20–0.81), after adjusting for Caucasian race (HR 0.31, 95 % CI 0.16–0.59), BCLC stage (HR 1.51, 95 % CI 0.21–1.89), and treatment (HR 0.57, 95 % CI 0.33–0.97). Conclusions: Role function has prognostic significance and is important to assess in patients with HCC.

AB - Background: Prior studies assessing quality of life (QOL) in patients with hepatocellular carcinoma (HCC) primarily included patients with preserved liver function and/or early HCC, leading to overestimation of QOL. Our study’s aim was to evaluate the association of QOL with survival among a cohort of cirrhotic patients with HCC that was diverse with respect to liver function and tumor stage. Methods: We conducted a prospective cohort study among cirrhotic patients with HCC from a large urban safety-net hospital between April 2011 and September 2013. Patients completed two self-administered surveys, the EORTC QLQ-C30 and QLQ-HCC18, prior to the treatment. We used generalized linear models to identify correlates of QOL. Survival curves were generated using Kaplan–Meier analysis and compared using log rank test to determine whether QOL is associated with survival. Results: A total of 130 treatment-naïve patients completed both surveys. Patients reported high cognitive and social function (median scores 67) but poor global QOL (median score 50) and poor role function (median score 50). QOL was associated with cirrhosis-related (p = 0.02) and tumor-related (p = 0.02) components of Barcelona Clinic Liver Cancer (BCLC) tumor stage. QOL was associated with survival on univariate analysis (HR 0.37, 95 % CI 0.16–0.85) but became nonsignificant (HR 0.82, 95 % CI 0.37–1.80) after adjusting for BCLC stage and treatment. Role functioning was significantly associated with survival (HR 0.40, 95 % CI 0.20–0.81), after adjusting for Caucasian race (HR 0.31, 95 % CI 0.16–0.59), BCLC stage (HR 1.51, 95 % CI 0.21–1.89), and treatment (HR 0.57, 95 % CI 0.33–0.97). Conclusions: Role function has prognostic significance and is important to assess in patients with HCC.

KW - Liver cancer

KW - Prognosis

KW - Quality of life

KW - Role function

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