title: Survival and health-related quality of life in patients with spinal metastases originated from primary hepatocellular carcinoma.
abstract: BACKGROUND
  In recent years, there have been more and more clinical trails focused on patient-reported outcomes (PRO), especially in the assessment of quality of life (QOL). Previous report on QOL assessment on patients with spinal metastases from primary hepatocellular carcinoma (HCC) is rare. And there is no standard treatment for those patients.
  
  
  OBJECTIVE
  The purpose of the current study is to determine whether spinal surgery could improve QOL in HCC patients with spinal metastases and prolong their survival.
  
  
  METHODS
  We conducted a single-center, non-randomized, prospective, longitudinal study in two groups: surgery group and non-surgery group. When diagnosed, all eligible patients completed a baseline QOL assessment using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. All patients' quality of life was subsequently assessed again at another 4 time points: 1, 3, 6 and 9 months after diagnosis.
  
  
  RESULTS
  From July 1, 2007 to March 31, 2009, we identified 62 patients (surgery group n = 29, non-surgery group n = 33) who were eligible for the observational study. Only 21 patients in the surgery group and 22 patients in the non-surgery group survived more than 9 months and completed all 5 follow-up QOL assessments. The median survival time was 12.6 months in the surgery group and 13.7 months in the non-surgery group (P = 0.530). The results suggested that whether in the surgery or non-surgery group, QOL scores in 9-month period after diagnosis decreased in the same mode, and surgical treatment for spinal metastases could improve neither patients' QOL nor survival.
  
  
  CONCLUSIONS
  Spinal surgery could not provide benefits for patients with spinal metastases from HCC in QOL or survival. We do not recommend surgical treatment for patients with metastases from HCC to the spine.
authors.affiliation: Department of Orthopedics, General Hospital of Chengdu Military Region, Chengdu, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Juan
authors.initials: J
authors.lastname: Wu
authors.forename: Jian-Ru
authors.initials: JR
authors.lastname: Xiao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Guo
mesh_terms: D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D011795:Surveys and Questionnaires; D015996:Survival Rate
keywords: Functional Assessment of Cancer Therapy‐Hepatobiliary; Health‐related quality of life; Primary hepatocellular carcinoma; Spinal metastases; Survival