title: Health-related quality of life as a prognostic factor in patients with advanced cancer.
abstract: BACKGROUND
  Evidence continues to accumulate regarding the association between health-related quality of life (HRQoL) and survival across chronic diseases. The objectives of the current study were to investigate the prognostic value of HRQoL in patients with hepatocellular carcinoma and cholangiocarcinoma after adjusting for sociodemographics, disease-related factors, and treatment-related factors.
  
  
  METHODS
  A total of 321 patients diagnosed with hepatocellular or cholangiocarcinoma were administered the Functional Assessment of Cancer Therapy-Hepatobiliary instrument. Cox regression and Kaplan-Meier survival analyses were performed to test the association between the 5 domains of HRQoL and survival.
  
  
  RESULTS
  Using Cox regression, overall HRQoL was found to be significantly associated with survival (P = .003) after adjusting for demographics, disease-specific factors, and treatment. Subscales of the Functional Assessment of Cancer Therapy-Hepatobiliary, including the Physical Well-Being (P = .02) and the Symptoms and Side Effects subscales (P = .05), were also found to be significantly associated with survival after adjusting for demographics, disease-specific factors, and treatment.
  
  
  CONCLUSIONS
  HRQoL was found to be prognostic of survival in patients with hepatocellular and cholangiocarcinoma while covarying for demographics, disease-specific factors, and treatment. Stratifying patients based on HRQoL when testing novel treatments may be recommended. Health-related quality of life was found to be prognostic of survival in patients with hepatocellular and cholangiocarcinoma while controlling for demographics, disease-specific factors, and treatment-related factors.
authors.affiliation: Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Steel
authors.forename: David A
authors.initials: DA
authors.lastname: Geller
authors.forename: Tiana L
authors.initials: TL
authors.lastname: Robinson
authors.forename: Alexandra Y
authors.initials: AY
authors.lastname: Savkova
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Brower
authors.forename: J Wallis
authors.initials: JW
authors.lastname: Marsh
authors.forename: Allan
authors.initials: A
authors.lastname: Tsung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D018281:Cholangiocarcinoma / Q000401:mortality* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life
keywords: advanced cancer; cholangiocarcinoma; hepatocellular carcinoma; palliative care; quality of life; survival
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