Quality of Life Is Associated with Survival in Patients with Cirrhosis and Hepatocellular Carcinoma

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dc.contributor.advisorSingal, Amit G.en
dc.contributor.committeeMemberYopp, Adamen
dc.contributor.committeeMemberBeg, Muhammaden
dc.creatorMeier, Adam Thomasen
dc.date.accessioned2019-08-02T19:14:05Z
dc.date.available2019-08-02T19:14:05Z
dc.date.created2014-05
dc.date.issued2014-04-11
dc.date.submittedMay 2014
dc.date.updated2019-08-02T19:14:06Z
dc.descriptionThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.en
dc.descriptionPages 1-24 are misnumbered as pages 2-25.en
dc.description.abstractBACKGROUND: Prior studies assessing quality of life (QOL) in patients with hepatocellular carcinoma (HCC) primarily included patients with preserved liver function and/or early HCC, leading to overestimation of QOL. OBJECTIVE: To characterize QOL among a diverse cohort of cirrhotic patients with HCC and evaluate its association with survival. METHODS: We conducted a prospective cohort study among cirrhotic patients with HCC from a large urban safety-net hospital between April 2011 and September 2013. Patients completed two self-administered surveys, the EORTC QLQ-C30, and QLQ-HCC18, prior to HCC-directed treatment. We used generalized linear models to identify correlates of QOL. Survival curves were generated using Kaplan-Meier analysis and compared using log rank test to determine if QOL is associated with survival. RESULTS: 130 treatment-naïve patients were enrolled and completed both surveys. Patients reported fair global QOL (median score 50%), high cognitive and social function (median scores 67%), but poor role function (median score 50%). QOL was associated with both cirrhosis-related (p=0.02) and tumor-related (p=0.02) components of Barcelona Clinic Liver Cancer (BCLC) stage. QOL was associated with survival on univariate analysis (HR 0.37, 95%CI 0.16-0.85) but became non-significant (HR 0.82, 95%CI 0.37-1.80) after adjusting for BCLC stage and treatment. Role functioning was significantly associated with survival (HR 0.40, 95%CI 0.20-0.81), after adjusting for Caucasian race (HR 0.31, 95%CI 0.16-0.59), BCLC stage (HR 1.51, 95%CI 0.21-1.89), and treatment (HR 0.57, 95%CI 0.33-0.97). CONCLUSION: QOL and role function have prognostic significance and are important to assess in cirrhotic patients with HCC.en
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc1111292009
dc.identifier.urihttps://hdl.handle.net/2152.5/7060
dc.language.isoenen
dc.subjectCarcinoma, Hepatocellularen
dc.subjectCognitionen
dc.subjectLiver Neoplasmsen
dc.subjectQuality of Lifeen
dc.subjectSocial Behavioren
dc.titleQuality of Life Is Associated with Survival in Patients with Cirrhosis and Hepatocellular Carcinomaen
dc.typeThesisen
dc.type.materialtexten
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineResearchen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameM.D. with Distinctionen

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