The association of liver function and quality of life of patients with liver cancer

Abstract

Background Quality of life (QOL) assessments with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, QLQ-HCC18, C30 and HCC18 index scores have been shown to be prognostic factors for overall survival (OS) in patients with hepatocellular carcinoma (HCC), independent of disease stage and liver function. Liver function parameters (including bilirubin, albumin, international normalized ratio [INR], Child-Pugh class, ALBI grade, MELD, alkaline phosphatase [ALP]-to-platelet ratio, albumin-to-ALP ratio) have also been found to be independent prognostic factors for OS in HCC patients. There has been scanty data on whether QOL and baseline liver function per se are correlated in HCC patients. This study investigates the correlations between baseline QOL data and liver function variables in HCC patients. Methods From 2007 to 2011, 517 patients were enrolled. Baseline QOL was assessed at diagnosis using the EORTC QLQ-C30 and QLQ-HCC18; thereafter C30 and HCC18 index scores were derived. Clinical and laboratory data were collected. For liver function assessment, Child-Pugh class, ALBI grade, MELD, ALP-to-platelet ratio and albumin-to-ALP ratio were derived. Correlation analyses were performed between QOL and liver function data. Results Complete QOL data were available in 472 HCC patients. After adjusting for clinical variables, significant correlations were found between QOL (QLQ-C30 and QLQ-HCC18) and dichotomized liver function variables (including Child-Pugh class, ALBI grade and the presence of ascites). It was demonstrated that QOL had significant and potentially clinically important correlations with continuous liver function variables (albumin, bilirubin, ALP and albumin-to-ALP ratio), with the highest Spearman’s rank correlation coefficient (rho) exceeding 0.4. HCC18 and C30 index scores were also significantly correlated with these liver function variables. HCC18 index score, which had rho up to 0.37, generally performed better than C30 index score, which had rho up to 0.33. Conclusions In HCC patients, baseline QOL assessment (using EORTC QLQ-C30, QLQ-HCC18, C30 index-score or HCC18 index-score) is significantly correlated with liver function. Based on the findings of this study, future trials are warranted to assess whether treatment to enhance liver function could improve HCC patients’ QOL.

The relationship between health-related quality of life and demographic characteristics in patients with chronic hepatitis B

“…A separate study revealed comparable HRQoL between inactive HBV carriers and healthy controls, but that this worsened as liver disease progressed. Significant impairment of HRQoL occurs in patients with CHB (15). The HRQoL of CHB patients can vary depending on their sociodemographic characteristics.…”

Image-Guided Proton Therapy for Elderly Patients with Hepatocellular Carcinoma: High Local Control and Quality of Life Preservation

“…We hypothesized that health-related QOL (HRQOL) may decrease in elderly patients due to complications and muscular weakness. The QOL scores of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 version 3.0 and QLQ-HCC18 were identified as prognostic factors for overall survival (OS) [ 13 , 14 ]; however, few studies included elderly patients.…”

Liver Fibrosis is Associated with a Decrease in Gait Speed in Older Men with Chronic Liver Disease: A Retrospective Cross-Sectional Study

“…3,4 Moreover, CLD causes a decline in the quality of life and activities of daily living (ADL) and an increase in the burden of care and the economic burden due to the medical costs. 5,6 In recent years, advances in the treatment of viral hepatitis have led to an aging population of patients with CLD.…”

“…3,4 Moreover, CLD causes a decline in the quality of life and activities of daily living (ADL) and an increase in the burden of care and the economic burden due to the medical costs. 5,6 In recent years, advances in the treatment of viral hepatitis have led to an aging population of patients with CLD.The burden of caring for the older has become critical with an increase in the world's population of older people, and it is important to prevent the need for nursing care. 7 In recent years, sarcopenia, a decline in skeletal muscle mass, muscle strength, and walking ability in older people, has been attracting attention from the perspective of preventing the need for nursing care.…”