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• Research Paper Volume 12, Issue 5 pp 4357-4370

  Elevated systemic inflammatory responses, factors associated with physical and mental quality of life, and prognosis of hepatocellular carcinoma

  Relevance score: 14.8975525

  Yang Deng, Jian Zhu, Ziyi Liu, Maosheng Huang, David W. Chang, Jian Gu

  Keywords: hepatocellular carcinoma, quality of life, age at diagnosis, systemic inflammatory response, Short Form-12

  Published in Aging on March 7, 2020

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  Impaired quality of life (QOL) is common in hepatocellular carcinoma (HCC) patients. In this study, we used a large hospital-based multiethnic HCC patient cohort to systematically identify factors associated with QOL and investigate the prognostic value of QOL.

  The Short Form-12 questionnaire was used to assess QOL. The Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were categorized into three groups (low, medium, and high) and ordered logistic regression analysis was used to analyze the association of PCS and MCS scores with patient characteristics. The association of PCS and MCS scores with mortality was assessed by Cox regression analysis.

  Notably, a panel of elevated systemic inflammatory response markers was associated with poor QOL. Other significant factors associated with QOL included age, liver function, sex, smoking, HCC etiology, and major clinical features. Patients with low (hazard ratio [95% CI], 1.72 [1.36-2.17]) and medium (1.52 [1.23-1.89]) PCS scores exhibited higher risks of death compared to patients with high PCS score. The association of MCS with the risk of death was not significant. These observations were consistent across all the different ethnicities.

  The identified factors associated with QOL may help clinicians formulate interventions to improve QOL and outcomes in HCC patients.

  

  Five-year overall survival rates of hepatocellular carcinoma patients by Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, categorized into tertiles. (A) PCS (Overall population, N = 735), (B) MCS (Overall population, N = 735), (C) PCS (Patients with stages I and II, N = 215), and (D) PCS (Patients with stages III and IV, N = 516). Higher scores indicate a better physical or mental quality of life. PCS: High, ≥ 45.0; Medium, ≥ 30.5, < 45.0; Low, < 30.5. MCS: High, ≥ 54.4; Medium, ≥ 41.3, < 54.4; Low, < 41.3.

  
  
  

  

  Five-year overall survival rates of hepatocellular carcinoma patients by Physical Component Summary (PCS) scores, stratified by race and ethnicity. (A) Non-Hispanic white (N = 469), (B) Hispanic (N = 128), (C) African American (N = 62), and (D) Asian (N = 76). PCS scores were categorized into tertiles. Higher scores indicate a better physical quality of life. PCS: High, ≥ 45.0; Medium, ≥ 30.5, < 45.0; Low, < 30.5.

  
  
  

  

  Forest plots of meta-analyses for the associations of risk of death with (A) Physical Component Summary (PCS) scores, and (B) Mental Component Summary (MCS) scores. The summary HR was estimated using random effects model.