P-0098 - Health Related Quality of Life and Survival in Patients Diagnosed with Hepatocellular Carcinoma and Treated with Transarterial Chemoembolization or...

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Presenter Kathryn Bress
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors K. Bress1, N. Amesur2, A. Tsung3, A. Zajko2, D. Geller3, J. Marsh4, J. Steel3
  • 1Department Of Surgery, Division Of Hepatobiliary And Pancreatic Surgery, University of Pittsburgh School of Medicine, Pittsburgh/US
  • 2University of Pittsburgh School of Medicine, Department of Radiology, Division of Interventional Radiology, Pittsburgh/US
  • 3University of Pittsburgh School of Medicine, Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Pittsburgh/US
  • 4University of Pittsburgh, Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Pittsburgh/US

Abstract

Introduction

Approximately 80% of patients diagnosed with hepatocellular carcinoma (HCC) are not candidates for surgery. The two primary regional therapies for HCC are transarterial chemoembolization (TACE) and Yttrium-90 (90Y). The aims of this study were to compare patients receiving these regional treatments on outcomes including survival and health related quality of life (HRQL).

Methods

A prospective study including 228 patients diagnosed with HCC and treated with TACE (n = 143) or 90Y (n = 85) were administered the Functional Assessment of Chemotherapy-Hepatobiliary (FACT-Hep) at baseline and at 3-and 6-months. Between group differences were examined using repeated measures ANOVA and survival using Kaplan-Meier and Cox regression analyses.

Results

Significant differences were observed at the time of diagnosis with patients receiving 90Y being older (64 versus 69 years, p < 0.001), more likely to be female (36% versus 20%, p = 0.008), and to not have vascular invasion (31% versus 49%, p = 0.01). No significant differences were found with regard to HRQL. After adjusting for age (p = 0 < 0.001), gender (p < 0.001), tumor size (p = 0.03), lesion number (p = 0.03) and vascular invasion (p = 0.04), patients treated with TACE reported statistically significantly better physical well-being scale of the FACT-Hep at 3-months and at 6-months (p = 0.05). At 3-months and 6-months, patients treated with TACE were found to have statistically significantly higher social-family well-being scores (p = 0.003). Using univariate survival analyses, tumor size (p = 0.04), and cirrhosis (p = 0.04) were found to be significantly related to survival. Using adjusted Cox regression for factors significantly related to survival in univariate analyses cirrhosis, tumor size and treatment group were not found to be significant predictors of survival when included in the final model.

Conclusion

After adjusting for baseline differences, TACE was shown to have better overall HRQL at 6-months follow-up. Using multivariate analysis, no difference in survival was observed between patients treated with TACE versus 90Y.