Real world impact of hepatocellular carcinoma stage and hepatic function on health-related quality of life.

person Amol Gupta Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD info_outline Amol Gupta, Jane Zorzi, Won Jin Ho, Marina Baretti, Nilofer Saba Azad, Paige Griffith, Doan Dao, Amy K. Kim, Benjamin Philosophe, Christos Georgiades, Ihab R. Kamel, Richard Burkhart, Robert Liddell, Kelvin Hong, Christopher Shubert, Kelly Lafaro, Jeffrey Meyer, Robert A. Anders, William Burns, Mark Yarchoan

Authors person Amol Gupta Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD info_outline Amol Gupta, Jane Zorzi, Won Jin Ho, Marina Baretti, Nilofer Saba Azad, Paige Griffith, Doan Dao, Amy K. Kim, Benjamin Philosophe, Christos Georgiades, Ihab R. Kamel, Richard Burkhart, Robert Liddell, Kelvin Hong, Christopher Shubert, Kelly Lafaro, Jeffrey Meyer, Robert A. Anders, William Burns, Mark Yarchoan Organizations Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD Abstract Disclosures Research Funding No funding received None. Background: Health-Related Quality of Life (HRQoL) is an important prognostic indicator and clinical endpoint for patients with hepatocellular carcinoma (HCC). The relationship between cancer stage, liver function, performance status, and HRQoL in HCC in a real-world clinical setting is not well defined. Methods: A retrospective chart review was undertaken of consecutive patients with HCC treated at our institution's liver multidisciplinary clinic between February 2020 and August 2022. We examined the relationship between Barcelona Clinic Liver Cancer (BCLC) stage, Child Pugh (CP) score, and Eastern Cooperative Oncology Group (ECOG) performance status on HRQoL at diagnosis. HRQoL was assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Results: Fifty-one patients met our inclusion criteria. The median age was 69 and the mean FACT-Hep score was 130.3 ± 20.3. FACT-Hep total and subscales showed no significant association with BCLC stages A, B, and C (p =0.224), except in the Emotional Well Being (EWB) subscale (p =0.001). There was no impact of ECOG performance status on the FACT-Hep scores, except for the Functional Well Being (FWB) subscale (p=0.006). Patients with a CP B had significantly more impairment in FACT-Hep than patients with CP A, including FACT-Hep total score (118.5 ±27.3 versus 134.3 ±23.8; p =0.021) and subscales including the Physical Well Being (p =0.018), FWB (p =0.030), Hepatobiliary Cancer Subscale (p <0.001), and FACT-Hep Trial Outcome Index score (p =0.003). Conclusions: Cancer stage poorly correlates with HRQoL at diagnosis in HCC patients. Impaired liver function reduces overall quality of life in HCC patients. Further large-scale prospective studies should be undertaken which incorporate validated HRQoL tools in the routine assessment of HCC patients. Impact of BCLC, ECOG, and CP on HRQoL in HCC patients. Variables, Mean ± SD PWB EWB FWB HCS FACT-Hep Trial FACT-Hep Total BCLC stage A 21.7±5.9 14.5±4.9 15.8±6.1 52.8±13.1 91.4±20.8 126.0±28.1 B 21.9±6.3 16.1±4.5 16.7±7.4 58.5±8.4 97.1±18.7 136.9±22.8 C 20.4±5.5 18.2±3.4 16.8±6.5 52.8±11.4 90.0±20.5 130.5±22.7 p-value 0.518 0.001 0.799 0.098 0.371 0.224 ECOG 0 22.2±5.3 15.4±4.5 18.1±6.2 55.5±10.4 95.8±19.3 132.6±24.3 1 20.1±6.5 17.2±4.6 14.5±6.5 52.5±13.2 88.0±21.2 127.3±27.0 p-value 0.174 0.140 0.006 0.354 0.166 0.577 Child-Pugh A 22.2±5.8 15.8±4.5 17.4±6.6 56.7±9.6 96.3±19.2 134.3±23.8 B 19.3±5.3 17.3±4.8 13.5±5.8 46.7±14.6 81.2±19.8 118.5±27.3 p-value 0.018 0.346 0.030 <0.001 0.003 0.021 BCLC: Barcelona Clinic Liver Cancer; ECOG: Eastern Cooperative Oncology Group; CP: Child-Pugh, FACT-Hep: Functional Assessment of Cancer Therapy-Hepatobiliary; PWB: physical well-being; SWB: social well-being; EWB: emotional well-being; FWB: functional well-being; HCS: hepatobiliary cancer subscale.