Quality of life as a prognostic factor of overall survival in patients with advanced hepatocellular carcinoma: results from two French clinical trials

Bonnetain, Franck; Paolettí, Xavier; Collette, Sandra; Doffoël, Michel; Bouche, O.; Raoul, Jean‐Luc; Rougier, Philippe; Masskouri, F.; Barbare, J.-C.; Bedenne, Laurent

doi:10.1007/s11136-008-9365-y

Cited by 58 publications

(45 citation statements)

References 57 publications

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“…Quality of life scores have correlated with survival in breast cancer [3,21], gastrointestinal cancers [4,5,19], thoracic malignancies [7,22], genitourinary cancers [8,23], head and neck cancers [24], and neurological malignancies [25,26]. Therefore, showing that quality of life in pancreatic and periampullary tumors is associated with functional status is additional evidence of the clinical importance of quality of life in cancer care.…”

Section: Discussionmentioning

confidence: 99%

“…Many oncology clinical trials have quality of life measures as some type of endpoint. Others have assessed quality of life as a predictor of patient outcomes in a variety of malignancies [3][4][5][6][7][8]. Previous work with pancreatic tumors has demonstrated that quality of life is associated with tumor pathology, stage, resectability, and survival [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Quality of life and performance status in patients with pancreatic and periampullary tumors

Velanovich

Wollner

2011

Int J Clin Oncol

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The results imply that pretreatment quality of life and performance status are related concepts in patients with pancreatic and periampullary tumors. This is primarily true for the physical component of the SF-36. However, despite statistical significance, coefficients of determination (r (2) values) suggest that there are additional factors determining both quality of life and performance status in patients with pancreatic and periampullary tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality of life and performance status in patients with pancreatic and periampullary tumors

Velanovich

Wollner

2011

Int J Clin Oncol

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“…Health-related quality of life (QOL) is an outcome of increasing interest after studies suggested it may be an independent prognostic factor in HCC patients [11–13]. Patients with HCC suffer from morbidity and poor QOL due to both hepatic dysfunction and tumor-related symptoms [14–16].…”

Section: Introductionmentioning

confidence: 99%

Role functioning is associated with survival in patients with hepatocellular carcinoma

et al. 2014

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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 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.

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“…Since validated stroke-specific QOL scales were not available at the time of the design of this study, we used a validated generic QOL scale, the Spitzer QLI, 9 which has been used extensively in prior research in various diseases. [10][11][12] METHODS The Northern Manhattan Study (NOMAS) includes a population-based incident ischemic stroke follow-up study designed to determine predictors of stroke recurrence and prognosis in a multiethnic, urban population consisting of 63% Hispanic, 20% black, and 15% white residents. 13,14 Selection of NOMAS cohort.…”

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confidence: 99%

Quality of life declines after first ischemic stroke

Dhamoon

Moon²,

Paik³

et al. 2010

Neurology

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Objectives: Quality of life (QOL) after stroke is poorly characterized. We sought to determine long-term natural history and predictors of QOL among first ischemic stroke survivors without stroke recurrence or myocardial infarction (MI). Methods:In the population-based, multiethnic Northern Manhattan Study, QOL was prospectively assessed at 6 months and annually for 5 years using the Spitzer QOL index (QLI), a 10-point scale. Functional status was assessed using the Barthel Index (BI) at regular intervals, and cognition using the Mini-Mental State Examination at 1 year. Generalized estimating equations estimated the association between patient characteristics and repeated QOL measures over 5 years. Follow-up was censored at death, recurrent stroke, or MI.Results: There were 525 incident ischemic stroke patients Ն40 years (mean age 68.6 Ϯ 12.4 years). QLI declined after stroke (annual change Ϫ0.10, 95% confidence interval Ϫ0.17 to Ϫ0.04), after adjusting for age, sex, race-ethnicity, education, insurance, depressed mood, stroke severity, bladder continence, and stroke laterality. This decline remained when BI Ն95 was added to the model as a time-dependent covariate, and functional status also predicted QLI. Changes in QLI over time differed by insurance status (p for interaction ϭ 0.0017), with a decline for those with Medicaid/no insurance (p Ͻ 0.0001) but not Medicare/private insurance (p ϭ 0.98). Conclusions:In this population-based study, QOL declined annually up to 5 years after stroke among survivors free of recurrence or MI and independently of other risk factors. QLI declined more among Medicaid patients and was associated with age, mood, stroke severity, urinary incontinence, functional status, cognition, and stroke laterality. Neurology ® 2010;75:328 -334 GLOSSARY BI ϭ Barthel Index; CAD ϭ coronary artery disease; CHF ϭ congestive heart failure; CI ϭ confidence interval; CUMC ϭ Columbia University Medical Center; DM ϭ diabetes mellitus; GEE ϭ generalized estimating equation; HTN ϭ hypertension; MI ϭ myocardial infarction; MMSE ϭ Mini-Mental State Examination; NIHSS ϭ NIH Stroke Scale; NOMAS ϭ Northern Manhattan Study; QOL ϭ quality of life; QLI ϭ quality of life index.Stroke causes a significant decrease in quality of life (QOL), even among those who have no poststroke disability.1 Prior studies examining QOL in stroke survivors have been limited by hospitalized samples, 2 cross-sectional design, 3 small sample sizes, 2 and samples with both hemorrhagic and ischemic strokes. 1,2,4,5 Longitudinal studies have been limited by short follow-up and enrollment of patients in different stages of early poststroke recovery. Few long-term population-based studies have systematically examined QOL after stroke. Those studies have been limited by few follow-up assessments 5,6 and significant loss to follow-up. 5 No study, to our knowledge, has censored recurrent vascular events, and the natural history and determinants of long-term QOL after a single ischemic stroke are not known. Finally, the effect of acce...

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Quality of life as a prognostic factor of overall survival in patients with advanced hepatocellular carcinoma: results from two French clinical trials

Abstract: Our results suggest that QoL is an independent prognostic factor for survival in HCC patients with mainly alcoholic cirrhosis. The prognostic value of CLIP score could be improved by adding Spitzer QOL Index scores.

Cited by 58 publications

References 57 publications

Quality of life and performance status in patients with pancreatic and periampullary tumors

Quality of life and performance status in patients with pancreatic and periampullary tumors

Role functioning is associated with survival in patients with hepatocellular carcinoma

Quality of life declines after first ischemic stroke

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