Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 4162
© 2005 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bonnetain, F. Search for Related Content PubMed Articles by Bonnetain, F.

Abstract

Multivariate quality of life (QoL) prognostic factor analysis in hepatocellular carcinoma (HCC)

INSERM EMI 106, Dijon, France; CHRU, Strasbourg, France; CHU Robert Debré, Reims, France; CHRU, Strasbourg, France; CHU Clermont-Ferrand, Clermont-Ferrand, France; Ctr Hospitalier de Belfort, Belfort, France; Assistance-publique des Hôpitaux de Paris, Paris, France; Ctr Hospitalier, Compiegne, France; FFCD, Dijon, France; CHRU Le Bocage, Dijon, France

4162

Background: The aim of this study was to explore whether pre-treatment quality of life (QoL) predicts survival in patients with non-operable HCC. Methods: Between 1995 and 2002, 123 eligible cirrhotic patients of Child-Pugh class A or B with unresectable HCC of Okuda stage I or II were included in a randomized multicentric phase III trial (FFCD 9402). At baseline, the clinician measured QoL ranging from 0 to 10 with Spitzer index. The overall survival (OS) was calculated until death or last follow-up using the Kaplan-Meier method. A univariate assessment of the prognostic effect of each baseline factor using Cox model was performed to calculated hazard ratio (HR) with 95% CI. Multivariate analysis was performed using backward stepwise Cox proportional hazards regression modeling (p = 0.05 to add and 0.10 to sort). Results: According to Spitzer QoL Index (N= 94) the median of OS ranged from 2.4 (Spitzer = 6) to 21.8 (Spitzer =10) months. It was respectively 3.9 and 18.6 months among patients with QoL < 9 (N=36) and 9 (N=58). Relevant or univariate significant factors included for multivariate analyses were: Spitzer (ordinal score, p< 0.0001), WHO performance status > 0 (p =0.015), sex (women vs men, NS), Okuda stage (II vs I, p< 0.0001), included patients by center < 6 (NS), treatment (Chemoembolization vs Tamoxifen, NS), alcohol cirrhosis (NS), Child-Pugh class (B vs A, p< 0.0001), hepatomegaly (p =0.03), hepatalgia (p< 0.0001), age 65 years, (NS), AFP 400 ng/ml (p< 0.0001), icterus (p=0.01), Diameter of the main nodule 5cm (p=0.14), tumor stage multinodular (p =0.014), and portal vein thrombosis (NS). Seven independent prognostic factors were retained by multivariate analysis: Spitzer QoL Index (HR = 0.79 [0.6 - 0.97]), Hepatalgia (HR = 2.31 [1.3 - 4.3], sex (HR = 0.49 [0.2 - 0.97], Child-Pugh (HR = 2.01 [1.2 - 3.44], AFP (HR = 2.47 [1.5 - 4.11], Center (HR = 2.46 [1.3 - 4.60]) and hepatomegaly (HR = 1.92 [1.2 - 3.12]). Conclusions: QoL could help individual HCC patient risk stratification and to plan future phase III trials.

No significant financial relationships to disclose.