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29-04-2019

Status of inflammation in relation to health related quality of life in hepatocellular carcinoma patients

Authors: Leung Li, Stephen L. Chan, Frankie Mo, Edwin P. Hui, Jane Koh, Allen KC Chan, Nelson LS Tang, Cheuk M. Chu, Joyce Hui, Kit F. Lee, Simon Yu, Winnie Yeo

Published in: Quality of Life Research | Issue 9/2019

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Abstract

Purpose

Both Inflammation and health-related quality of life (HRQoL) are independent prognosticators in HCC patients. We hypothesized that inflammation can cause impairment in HRQoL and investigated the correlation between inflammatory status and HRQoL in HCC patients.

Methods

Clinical, laboratory and HRQoL (using EORTC QLQ-C30, QLQ-HCC18, C30 and HCC18 index-scores) data were prospectively collected from HCC patients at diagnosis. Correlation analyses were performed between HRQoL and inflammation-based markers including C-reactive protein (CRP), CRP/albumin ratio (CRP/alb), Glasgow Prognostic Score (GPS), Inflammation-Based Index (IBI) and Prognostic Index (PI).

Results

Among 445 HCC patients, higher inflammatory states were significantly correlated with worse HRQoL. For CRP and CRP/alb ratio, the HRQoL factors with higher correlations included C30 and HCC18 index-scores, certain QLQ-C30 domains and items (‘physical functioning’, ‘role functioning’, ‘fatigue’, ‘pain’, ‘appetite loss’) and QLQ-HCC18 items (‘fatigue’, ‘body image’, ‘nutrition’ and ‘abdominal swelling’), where the Pearson’s correlation coefficients were up to 0.416. Multivariate analyses indicated that worse HRQoL factors were significantly correlated with worse scores in GPS, IBI and PI.

Conclusion

In HCC patients, inflammatory status correlates with HRQoL at presentation. In particular, relatively stronger correlations with CRP-based markers have been observed in HRQoL scales that assess constitutional symptoms (QLQ-C30 ‘physical functioning’, ‘role functioning’, ‘fatigue’, ‘appetite loss’ and QLQ-HCC18 ‘fatigue’ and ‘nutrition’) and tumor burden (QLQ-C30 ‘pain’ and QLQ-HCC18 ‘abdominal swelling’ and ‘body image’). Future studies are warranted to evaluate whether intervention that reduces inflammation could improve HRQoL in HCC patients.

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Title: Status of inflammation in relation to health related quality of life in hepatocellular carcinoma patients
Authors: Leung Li
Stephen L. Chan
Frankie Mo
Edwin P. Hui
Jane Koh
Allen KC Chan
Nelson LS Tang
Cheuk M. Chu
Joyce Hui
Kit F. Lee
Simon Yu
Winnie Yeo
Publication date: 29-04-2019
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 9/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-019-02190-0

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Abstract

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