Abstract
4643 Background: Accumulating evidence suggests that health related quality of life (HRQL) is prognostic of survival across several disease types, including cancer. The aims of the present study were to (1) assess the prognostic value of HRQL with a disease-specific instrument, and (2) explore linear and non-linear associations between HRQL and survival in patients diagnosed with unresectable hepatocellular carcinoma. Methods: A prospective study study of 166 patients diagnosed with hepatobiliary carcinoma and referred for treatment were administered the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) to assess HRQL. Survival was measured from diagnosis to death. Results: Using Cox regression and Kaplan Meier survival analyses, baseline overall HRQL (p=0.05) and the physical well-being scale (p=0.04) was found to significantly predict survival while controlling for sociodemographic (i.e., age) and disease- specific variables (i.e., etiology, tumor size, number of lesions, vascular invasion, alpha-fetoprotein, bilirubin, prothrombin time). A linear association between overall HRQL and survival was observed with patients reporting overall HRQL scores in the highest tertile having a mean survival of 19.4 months, the middle tertile with a mean survival of 17.6 months, and the lowest tertile having a mean survival of 17.2 months. A similar trend in mean survival was found for patients who reported physical well being in the highest tertile (15 months), middle tertile (11 months), and lowest tertile (5 months) of this subscale. The disease-specific module of the FACT-Hep was not found to significantly predict survival, however a robust trend was revealed (p=0.06). Conclusion: Overall HQRL and the physical well-being scale were found to be prognostic for patients with HCC. A linear relationship was found between HRQL and survival and a robust trend was found in regard to the association between the disease-specific module of the FACT-Hep and survival. With accumulating evidence regarding the prognostic value of HRQL, stratification of patients in clinical trials based on baseline HRQL may be recommended. HRQL may represent an important element in new prognostic systems for HCC. No significant financial relationships to disclose.
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