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Zhang X, Liu P, Fu Q, Luo QK, Yu PF, Chen JY, Wang YZ, Qin T. Partial response of hepatocellular carcinoma to lenalidomide following progression in response to lenvatinib: A case report. Exp Ther Med 2024; 28:352. [PMID: 39071899 PMCID: PMC11273340 DOI: 10.3892/etm.2024.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/22/2024] [Indexed: 07/30/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most aggressive types of cancer. Although it has a high mortality rate, there is currently no effective treatment for HCC. Lenvatinib has traditionally been used as the first-line treatment for advanced HCC (aHCC); however, resistance to this therapy is common. It can be difficult to select effective second-line drugs to overcome lenvatinib resistance when treating aHCC. For patients with aHCC, poor treatment efficacy can result in patients missing the optimal treatment window and can lead to an irreversible situation. Lenalidomide has begun to be used to treat HCC; however, to the best of our knowledge, its efficacy in patients with lenvatinib-resistant HCC remains to be reported on in the literature. The present case report, to the best of our knowledge, describes the first case in the literature of a patient with lenvatinib-resistant aHCC who achieved a partial response after the treatment regimen was switched to lenalidomide. The present case report provides a promising novel route for the treatment of lenvatinib-resistant HCC.
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Affiliation(s)
- Xu Zhang
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Pan Liu
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Qiang Fu
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Qian-Kun Luo
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Peng-Fei Yu
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Jing-Yu Chen
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Yu-Zhu Wang
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
| | - Tao Qin
- Department of Hepato-Biliary-Pancreatic Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, P.R. China
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2
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Fontesse S, Fournier V, Gérain P, Dassonneville C, Lelorain S, Duprez C, Christophe V, Piessen G, Grynberg D. Happy thus survivor? A systematic review and meta-analysis on the association between cancer survival and positive states, emotions, and traits. Psychooncology 2023; 32:1631-1643. [PMID: 37798951 DOI: 10.1002/pon.6224] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/14/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES Traditionally, the literature investigating patient-reported outcomes in relation to cancer survival focused on negative factors such as distress. Meta-analyses in this field have provided a clear identification of negative affect that reduce cancer survival (e.g., depression). Nevertheless, positive psychological factors and especially positive affect might be equally crucial for cancer survival but have been neglected so far. While studies in this domain have been conducted, they remain less numerous and have produced mixed results. METHODS A pre-registered systematic review and meta-analysis (https://osf.io/jtw7x) aimed at identifying the positive affect linked to mortality in cancers were conducted. Four databases (Pubmed, PsycINFO, Embase, and Cochrane Library) were searched to find longitudinal studies linking positive affect to survival in cancers. Two reviewers completed each stage of the study selection process, the data extraction, and the Quality in Prognosis Studies risk of bias assessments. RESULTS Twenty-four studies involving 822,789 patients were included based on the 2462 references identified. The meta-analysis reveals that positive affect is associated with longer survival (Hazard Ratio [HR] = 0.91; 95% CI [0.86, 0.96], z = -3.58, p < 0.001) and lower mortality (Odd Ratio [OR] = 0.59; 95% CI [0.45, 0.78], z = -3.70, p < 0.001). Sub-group analyses indicated that the main predictors of survival are emotional and physical well-being, optimism, and vitality. CONCLUSION This work emphasizes the need to consider the role of affective mechanisms in patients with cancer, including their levels of well-being or optimism to provide the most favorable conditions for survival. Therefore, stronger and continuous effort to improve patients' positive affect could be particularly beneficial for their life expectancy.
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Affiliation(s)
- Sullivan Fontesse
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | - Valentyn Fournier
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | - Pierre Gérain
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Psychology, Educational Sciences, and Speech and Language Therapy, Université Libre de Bruxelles, Brussels, Belgium
| | - Charlotte Dassonneville
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | | | - Christelle Duprez
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | - Véronique Christophe
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Centre de Recherche en Cancérologie de Lyon - UCBL, CRCL UMR Inserm 1052 - CNRS 5286, Université Claude Bernard Lyon 1, Lyon, France
| | - Guillaume Piessen
- University Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies, Univ. Lille, Lille, France
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Univ. Lille, Lille, France
| | - Delphine Grynberg
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- Institut Universitaire de France, Paris, France
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Gupta A, Zorzi J, Ho WJ, Baretti M, Azad NS, Griffith P, Dao D, Kim A, Philosophe B, Georgiades C, Kamel I, Burkhart R, Liddell R, Hong K, Shubert C, Lafaro K, Meyer J, Anders R, Burns III W, Yarchoan M. Relationship of Hepatocellular Carcinoma Stage and Hepatic Function to Health-Related Quality of Life: A Single Center Analysis. Healthcare (Basel) 2023; 11:2571. [PMID: 37761768 PMCID: PMC10531156 DOI: 10.3390/healthcare11182571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Health-related quality of life (HRQoL) is known to be an important prognostic indicator and clinical endpoint for patients with hepatocellular carcinoma (HCC). However, the correlation of the Barcelona Clinic Liver Cancer (BCLC) stage with HRQoL in HCC has not been previously studied. We examined the relationship between BCLC stage, Child-Pugh (CP) score, and Eastern Cooperative Oncology Group (ECOG) performance status on HRQoL for patients who presented at a multidisciplinary liver cancer clinic. HRQoL was assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Fifty-one patients met our inclusion criteria. The FACT-Hep total and subscales showed no significant association with BCLC stages (p = 0.224). Patients with CP B had significantly more impairment in FACT-Hep than patients with CP A. These data indicate that in patients with HCC, impaired liver function is associated with reduced quality of life, whereas the BCLC stage poorly correlates with quality of life metrics. Impairment of quality of life is common in HCC patients and further studies are warranted to determine the impact of early supportive interventions on HRQoL and survival outcomes.
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Affiliation(s)
- Amol Gupta
- The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD 21287, USA; (J.Z.); (W.J.H.); (M.B.); (N.S.A.); (P.G.); (D.D.); (A.K.); (B.P.); (C.G.); (I.K.); (R.B.); (R.L.); (K.H.); (C.S.); (K.L.); (J.M.); (R.A.); (W.B.III); (M.Y.)
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4
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Nguyen HV, Byeon H. LIME-based ensemble machine for predicting performance status of patients with liver cancer. Digit Health 2023; 9:20552076231211636. [PMID: 38025102 PMCID: PMC10631338 DOI: 10.1177/20552076231211636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The Eastern Cooperative Oncology Group performance status (ECOG PS) is a widely recognized measure used to assess the functional abilities of cancer patients and predict their prognosis. It plays a crucial role in guiding treatment decisions made by physicians. This study aimed to build a stacking ensemble-based prognosis predictor model for predicting the ECOG PS of a liver cancer patient undergoing treatment. Methods We used Light Gradient Boosting Machine (LightGBM) as the meta-model, and five base models, including Random Forest (RF), Extra Trees (ET), AdaBoost (Ada), Gradient Boosting Machine (GBM), and Extreme Gradient Boosting (XGBoost). After preprocessing the data and applying feature selection method, the stacking ensemble model was trained using 1622 liver cancer patients' data and 46 variables. We also integrated the stacking ensemble model with a LIME-based explainable model to obtain model prediction explainability. Results According to the research, the best combination of the stacking ensemble model is ET + XGBoost + RF + GBM + Ada + LightGBM and achieved a ROC AUC of 0.9826 on the training set and 0.9675 on the test set. Conclusions This explainable stacking ensemble model can become a helpful tool for objectively predicting ECOG PS in liver cancer patients and aiding healthcare practitioners to adapt their treatment approach more effectively.
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Affiliation(s)
- Hung Viet Nguyen
- Department of Digital Anti-Aging Healthcare (BK21), Inje University, Gimhae, Republic of Korea
| | - Haewon Byeon
- Department of Digital Anti-Aging Healthcare (BK21), Inje University, Gimhae, Republic of Korea
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Leith A, Kiiskinen U, Girvan AC, Jen MH, Khela K, Rider A, Massey L, Piercy J. Physician- and patient-reported symptom concordance and association with quality of life in hepatocellular carcinoma. Future Oncol 2022; 18:3727-3740. [PMID: 36377818 DOI: 10.2217/fon-2022-0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To investigate the association of discordance in patient- and physician-reported symptoms on health-related quality of life (HRQoL) in hepatocellular carcinoma (HCC). Patients & methods: Data were drawn from a point-in-time survey of physicians and patients conducted in Germany, Italy and Spain (October 2018 - January 2019). Physicians and their consulting patients independently reported baseline characteristics, symptoms, treatment history and satisfaction, and HRQoL derived using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Results: Of 486 patients analysed, tiredness (73.3%, 73.7%), pain/aches (67.7%, 66.9%) and weight/appetite loss (54.3%, 53.7%) were the most common and concordant patient and physician-reported symptom domains, respectively. The symptom domains showing the largest discordance were reflux/indigestion (14.6%, 5.1%), neurological (11.9%, 5.6%), dermatological (9.3%, 6.2%) symptoms and jaundice (4.7%, 10.3%). Reduced HRQoL was observed with increasing symptom-reporting discordance. Conclusion: Further studies should investigate how symptom-reporting discordance influences patient satisfaction and HRQoL.
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Affiliation(s)
- Andrea Leith
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Urpo Kiiskinen
- Eli Lilly & Company, Laajalahdentie 23, 00330 Helsinki, Finland
| | - Allicia C Girvan
- Eli Lilly & Company, Lilly Corporate Center, Indianapolis, Indiana, 46285, USA
| | - Min-Hua Jen
- Eli Lilly & Company, 8 Arlington Square West, Downshire Way Bracknell, RG12 1PU, UK
| | - Keerun Khela
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Alex Rider
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Lucy Massey
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - James Piercy
- Adelphi Real World, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
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Serper M, Parikh ND, Thiele G, Ovchinsky N, Mehta S, Kuo A, Ho C, Kanwal F, Volk M, Asrani SK, Ghabril MS, Lake JR, Merriman RB, Morgan TR, Tapper EB. Patient-reported outcomes in HCC: A scoping review by the Practice Metrics Committee of the American Association for the Study of Liver Diseases. Hepatology 2022; 76:251-274. [PMID: 34990516 PMCID: PMC10648308 DOI: 10.1002/hep.32313] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS HCC is a leading cause of mortality in patients with advanced liver disease and is associated with significant morbidity. Despite multiple available curative and palliative treatments, there is a lack of systematic evaluation of patient-reported outcomes (PROs) in HCC. APPROACH AND RESULTS The American Association for the Study of Liver Diseases Practice Metrics Committee conducted a scoping review of PROs in HCC from 1990 to 2021 to (1) synthesize the evidence on PROs in HCC and (2) provide recommendations on incorporating PROs into clinical practice and quality improvement efforts. A total of 63 studies met inclusion criteria investigating factors associated with PROs, the relationship between PROs and survival, and associations between HCC therapy and PROs. Studies recruited heterogeneous populations, and most were cross-sectional. Poor PROs were associated with worse prognosis after adjusting for clinical factors and with more advanced disease stage, although some studies showed better PROs in patients with HCC compared to those with cirrhosis. Locoregional and systemic therapies were generally associated with a high symptom burden; however, some studies showed lower symptom burden for transarterial radiotherapy and radiation therapy. Qualitative studies identified additional symptoms not routinely assessed with structured questionnaires. Gaps in the literature include lack of integration of PROs into clinical care to guide HCC treatment decisions, unknown impact of HCC on caregivers, and the effect of palliative or supportive care quality of life and health outcomes. CONCLUSION Evidence supports assessment of PROs in HCC; however, clinical implementation and the impact of PRO measurement on quality of care and longitudinal outcomes need future investigation.
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Affiliation(s)
- Marina Serper
- Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Section of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania, USA
| | - Neehar D Parikh
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Grace Thiele
- Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nadia Ovchinsky
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital at Montefiore-Albert Einstein College of Medicine, Bronx, New York, USA
| | - Shivang Mehta
- Hepatology, Baylor All Saints, Fort Worth, Texas, USA
| | - Alexander Kuo
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Chanda Ho
- Department of Transplantation, California Pacific Medical Center, San Francisco, California, USA
| | - Fasiha Kanwal
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Michael Volk
- Division of Gastroenterology and Transplantation Institute, Loma Linda University, Loma Linda, California, USA
| | - Sumeet K Asrani
- Hepatology, Baylor University Medical Center, Dallas, Texas, USA
| | - Marwan S Ghabril
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John R Lake
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Elliot B Tapper
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
- Gastroenterology Section, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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7
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Wohlleber K, Heger P, Probst P, Engel C, Diener MK, Mihaljevic AL. Health-related quality of life in primary hepatic cancer: a systematic review assessing the methodological properties of instruments and a meta-analysis comparing treatment strategies. Qual Life Res 2021; 30:2429-2466. [PMID: 34283381 PMCID: PMC8405513 DOI: 10.1007/s11136-021-02810-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Patient-reported outcomes including health-related quality of life (HRQoL) are important oncological outcome measures. The validation of HRQoL instruments for patients with hepatocellular and cholangiocellular carcinoma is lacking. Furthermore, studies comparing different treatment options in respect to HRQoL are sparse. The objective of the systematic review and meta-analysis was, therefore, to identify all available HRQoL tools regarding primary liver cancer, to assess the methodological quality of these HRQoL instruments and to compare surgical, interventional and medical treatments with regard to HRQoL. METHODS A systematic literature search was conducted in MEDLINE, the Cochrane library, PsycINFO, CINAHL and EMBASE. The methodological quality of all identified HRQoL instruments was performed according to the COnsensus-based Standards for the selection of health status Measurements INstruments (COSMIN) standard. Consequently, the quality of reporting of HRQoL data was assessed. Finally, wherever possible HRQoL data were extracted and quantitative analyses were performed. RESULTS A total of 124 studies using 29 different HRQoL instruments were identified. After the methodological assessment, only 10 instruments fulfilled the psychometric criteria and could be included in subsequent analyses. However, quality of reporting of HRQoL data was insufficient, precluding meta-analyses for 9 instruments. CONCLUSION Using a standardized methodological assessment, specific HRQoL instruments are recommended for use in patients with hepatocellular and cholangiocellular carcinoma. HRQoL data of patients undergoing treatment of primary liver cancers are sparse and reporting falls short of published standards. Meaningful comparison of established treatment options with regard to HRQoL was impossible indicating the need for future research.
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Affiliation(s)
- Kerstin Wohlleber
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Patrick Heger
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
- The Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Pascal Probst
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
- The Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Härtelstraße 16-18, 04107, Leipzig, Germany
| | - Markus K Diener
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
- The Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - André L Mihaljevic
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
- The Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
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Moser M, Radu IP, Dufour JF. Effects of Home Care on patients with hepatocellular carcinoma treated with sorafenib. JGH OPEN 2021; 5:864-870. [PMID: 34386593 PMCID: PMC8341184 DOI: 10.1002/jgh3.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/07/2021] [Accepted: 03/11/2021] [Indexed: 11/12/2022]
Abstract
Background and Aim Treatment with sorafenib causes diverse side effects, which limits adherence. This work assesses whether Home Care, a psychosocial nursing intervention, prolongs the duration of treatment in patients with advanced hepatocellular carcinoma (HCC) and if it influences health-related quality of life (HRQL). Methods and Results This is a cohort study using data from patients receiving sorafenib in the prospective Bern HCC Cohort at the University Hospital. Duration of treatment, overall survival, and HRQL using the Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire were compared in the two groups. A total of 173 patients were eligible for the analysis. Among them, 141 were in the Home Care program, and 32 were not. Patients with Home Care had a significantly longer duration of treatment (265 days vs 152 days, P = 0.003) and a better functional well-being (17.7 vs 12.5, P = 0.015). Conclusion Psychosocial interventions such as Home Care are a valid method in improving adherence to sorafenib and can therefore be recommended.
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Affiliation(s)
- Monika Moser
- Hepatology, Department of Clinical Research University of Bern Bern Switzerland.,University Clinic for Visceral Surgery and Medicine, Inselspital Bern Switzerland
| | - Iuliana-Pompilia Radu
- Hepatology, Department of Clinical Research University of Bern Bern Switzerland.,University Clinic for Visceral Surgery and Medicine, Inselspital Bern Switzerland
| | - Jean-François Dufour
- Hepatology, Department of Clinical Research University of Bern Bern Switzerland.,University Clinic for Visceral Surgery and Medicine, Inselspital Bern Switzerland
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9
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Verma M, Younossi Z. Integrating Patient-Reported Outcomes Within Routine Hepatology Care: A Prompt to Action. Hepatology 2021; 73:1570-1580. [PMID: 32918286 DOI: 10.1002/hep.31550] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/10/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Manisha Verma
- Department of Digestive Diseases and Transplantation, Einstein Healthcare Network, Philadelphia, PA
| | - Zobair Younossi
- Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA
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10
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Firkins JL, Tarter R, Driessnack M, Hansen L. A closer look at quality of life in the hepatocellular carcinoma literature. Qual Life Res 2021; 30:1525-1535. [PMID: 33625648 DOI: 10.1007/s11136-021-02789-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE Adults with hepatocellular carcinoma (HCC) have a high symptom burden. Their quality of life (QOL) has been shown to be significantly impacted by both the disease and its treatment, adding to the high symptom burden that these patients experience. The primary aims of this paper are as follows: (1) to identify how QOL is being defined in HCC literature and (2) to identify how QOL is being measured in the HCC literature using Ferrell's model of QOL. METHODS A systematic review was completed of relevant studies published after 2014, using PubMed, CINHAL, and PsycInfo. Relevant studies were reviewed by 2 reviewers using PRISMA guidelines. RESULTS From a total of 1312 papers obtained in the initial database search, 30 met inclusion criteria and are included in this review. From the included articles, 10% included a definition of QOL and 3% addressed the spiritual domain of QOL. Majority of study participants were in the early stage of HCC, though the majority of adults with HCC are diagnosed in the advanced stage. Only 3% of included studies included greater than 22% population of advanced stage of HCC. CONCLUSION The results of this systematic review demonstrate the need for future research into QOL in the advanced stage of QOL. It also identified gap in the literature concerning the definition of QOL in HCC and the spiritual domain of QOL in HCC.
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Affiliation(s)
- Jenny L Firkins
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
| | - Robin Tarter
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Lissi Hansen
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
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11
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Deng Y, Zhu J, Liu Z, Huang M, Chang DW, Gu J. Elevated systemic inflammatory responses, factors associated with physical and mental quality of life, and prognosis of hepatocellular carcinoma. Aging (Albany NY) 2020; 12:4357-4370. [PMID: 32145060 PMCID: PMC7093167 DOI: 10.18632/aging.102889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/24/2020] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Yang Deng
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jian Zhu
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ziyi Liu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maosheng Huang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - David W Chang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jian Gu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Real-world role of performance status in surgical resection for hepatocellular carcinoma: A multicenter study. Eur J Surg Oncol 2019; 45:2360-2368. [DOI: 10.1016/j.ejso.2019.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/27/2019] [Accepted: 09/11/2019] [Indexed: 01/27/2023] Open
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Das A, Gabr A, O'Brian DP, Riaz A, Desai K, Thornburg B, Kallini JR, Mouli S, Lewandowski RJ, Salem R. Contemporary Systematic Review of Health-Related Quality of Life Outcomes in Locoregional Therapies for Hepatocellular Carcinoma. J Vasc Interv Radiol 2019; 30:1924-1933.e2. [PMID: 31685362 DOI: 10.1016/j.jvir.2019.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 06/03/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022] Open
Abstract
Health-related quality of life has become an important aspect in oncologic decision making. Recent data suggest that Health-Related Quality of Life (HRQoL) measurements can play an important prognostic role in patients with hepatocellular carcinoma (HCC). Locoregional therapies (LRTs) such as radiofrequency ablation, transarterial chemoembolization, and radioembolization (TARE) are important parts of HCC management. Results demonstrated that radiofrequency ablation treatment results in improving HRQoL compared to surgery for up to 3 years after treatment. Between TARE and transarterial chemoembolization, TARE provides the most benefit in terms of HRQoL. This systematic review investigated contemporary data surrounding HRQoL in patients undergoing LRTs and its impact on clinical decision making.
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Affiliation(s)
- Arighno Das
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Ahmed Gabr
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Daniel P O'Brian
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Ahsun Riaz
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Kush Desai
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Bartley Thornburg
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Joseph R Kallini
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Samdeep Mouli
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois
| | - Robert J Lewandowski
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois; Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago Illinois
| | - Riad Salem
- Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago Illinois; Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago Illinois.
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Casadei-Gardini A, Solaini L, Riggi L, Molinaro E, Dadduzio V, Rizzato MD, Pellino A, Faloppi L, Marisi G, Ulivi P, Canale M, Orsi G, Rovesti G, Andrikou K, Spallanzani A, Gelsomino F, Foschi FG, Conti F, Cucchetti A, Ercolani G, Biason P, Lonardi S, Cascinu S, Scartozzi M. Prognostic Role of a New Index (RAPID Index) in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib: Training and Validation Cohort. Gastrointest Tumors 2019; 6:71-80. [PMID: 31768351 DOI: 10.1159/000501593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022] Open
Abstract
Background and Aims The aim of the present study is to evaluate a new index influenced by the balance between the immune system, α-fetoprotein (AFP), and lactate dehydrogenase (LDH) (RAPID index) as a prognostic factor in patients treated with sorafenib. Methods This study was conducted on a training cohort of 159 hepatocellular carcinoma (HCC) patients and a validation cohort of 68 HCC patients treated with sorafenib. The RAPID index was calculated as neutrophil/lymphocyte count × LDH × AFP. Results In the training cohort, the median overall survival (OS) was 23.2 months (95% CI 11-25) and 12.1 months (95% CI 9-15) for patients with a low (≤3,226) and high (>3,226) RAPID index, respectively (ref. <3,226, HR = 0.56, 95% CI 0.35-0.88, p = 0.017). Following adjustment for clinical covariates, multivariate analysis confirmed the RAPID index ≤3,226 versus >3,226 (HR = 0.37, 95% CI 0.18-0.74, p = 0.0054) as an independent prognostic factor for OS. In the validation cohort, the median OS was 26.9 months (95% CI 17.6-26.9) and 7.0 months (95% CI 6.2-9.2) for patients with a low (≤ 3,226) and high (>3,226) RAPID index, respectively (ref. <3,226, HR = 0.19, 95% CI 0.10-0.36, p < 0.0001). Performing the same multivariate analysis of the training cohort (AFP, Eastern Cooperative Oncology Group, aspartate aminotransferase, neutrophil, platelet, systemic inflammatory index and RAPID index), the RAPID index <3,226 versus >3,226 (HR = 3.86, 95% CI 1.45-10.29, p = 0.007) was found to be an independent prognostic factor for predicting OS. Conclusion The low cost, easy assessment, and reproducibility of a full blood count make the RAPID index a promising tool for assessing HCC prognosis in future clinical practice.
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Affiliation(s)
- Andrea Casadei-Gardini
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Leonardo Solaini
- Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,General and Oncology Surgery, Morgagni-Pierantoni Hospital, Forli, Italy
| | - Laura Riggi
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Eleonora Molinaro
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Vincenzo Dadduzio
- Unit of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | - Antonio Pellino
- Unit of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Luca Faloppi
- Medical Oncology, University Hospital of Cagliari, Cagliari, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Matteo Canale
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giulia Orsi
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Giulia Rovesti
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Kalliopi Andrikou
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Andrea Spallanzani
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Fabio Gelsomino
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | | | - Fabio Conti
- Department of Internal Medicine, Degli Infermi Hospital, Faenza, Italy
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,General and Oncology Surgery, Morgagni-Pierantoni Hospital, Forli, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy.,General and Oncology Surgery, Morgagni-Pierantoni Hospital, Forli, Italy
| | - Paola Biason
- Unit of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Sara Lonardi
- Unit of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Stefano Cascinu
- Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Modena, Italy
| | - Mario Scartozzi
- Unit of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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Wehling C, Hornuss D, Schneider P, Springfeld C, Hoffmann K, Chang DH, Naumann P, Mieth M, Longerich T, Kratochwil C, Mehrabi A, Gauss A, Weiss KH, Pfeiffenberger J. Impact of interventions and tumor stage on health-related quality of life in patients with hepatocellular carcinoma. J Cancer Res Clin Oncol 2019; 145:2761-2769. [DOI: 10.1007/s00432-019-03005-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023]
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