Author information
1
Dep of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
2
Center for Digestive Diseases, Unit of Hepatology, Karolinska University Hospital, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
3
Dep of Surgery, University Hospital North Norway, Tromsø, Norway.
4
Dep of Community Medicine, The Arctic University of Norway, Norway.
5
Dep of Oncology, University Hospital of North Norway, Tromsø, Norway.
6
Dep of Oncology, Oslo University Hospital, Oslo, Norway.
Abstract
BACKGROUND & AIMS:
Prognostication in hepatocellular carcinoma (HCC) is demanding. Not only tumor 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 if 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, radiologic 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 was 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.