Verma Manisha, Paik James M, Younossi Issah, Tan Daisong, Abdelaal Hala, Younossi Zobair M
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.
Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
Cancer Med. 2021 Sep;10(18):6273-6281. doi: 10.1002/cam4.4166. Epub 2021 Aug 18.
Patients with hepatocellular cancer (HCC) are known to have worse health-related quality of life (HRQL) than the general population. However, the change in HRQL from before the diagnosis to after diagnosis remains unknown and is difficult to estimate. We aimed to compare HCC cases with matched controls to evaluate the differences in change in HRQL from before to after HCC diagnosis.
We performed propensity score-matched analysis using the self-reported HRQL data from the Surveillance, Epidemiology, and End Results registries (SEER) data linked with Medicare Health Outcomes Survey (MHOS) data (1998-2014). Cases were selected as Medicare beneficiaries (aged ≥65 years) who were diagnosed with HCC between their baseline assessment and follow-up assessment. Matched controls were selected from the same data resource and the same time period to include subjects without cancer diagnosis by propensity scores. HRQL was assessed using the Medical Outcomes Study Short Form-36 (SF-36).
The study included 62 subjects who developed HCC and 365 matched controls. Compared to their baseline HRQL scores, after diagnosis of HCC, subjects were more likely to report declines in scores related to the mental component of HRQL. When stratified by time since diagnosis, mental component remained significantly lower as the disease advanced. In contrast, only general health aspects of physical health worsened after HCC diagnosis.
Diagnosis of HCC has a profound negative impact on patients' HRQL. Mental health component deteriorated significantly over time. The need of including mental health services within a multidisciplinary HCC care model is clearly evident.
已知肝细胞癌（HCC）患者的健康相关生活质量（HRQL）比普通人群更差。然而，从诊断前到诊断后HRQL的变化仍不清楚且难以估计。我们旨在比较HCC病例与匹配的对照组，以评估HCC诊断前后HRQL变化的差异。
我们使用来自监测、流行病学和最终结果登记处（SEER）数据与医疗保险健康结果调查（MHOS）数据（1998 - 2014年）相链接的自我报告HRQL数据进行倾向评分匹配分析。病例被选为在基线评估和随访评估之间被诊断为HCC的医疗保险受益人（年龄≥65岁）。匹配的对照组从相同的数据资源和相同的时间段中选择，以纳入通过倾向评分未被诊断患有癌症的受试者。使用医疗结果研究简表36（SF - 36）评估HRQL。
该研究包括62名发生HCC的受试者和365名匹配的对照组。与他们的基线HRQL评分相比，在诊断为HCC后，受试者更有可能报告与HRQL心理成分相关的评分下降。按诊断后的时间分层时，随着疾病进展，心理成分仍然显著较低。相比之下，HCC诊断后仅身体健康的总体健康方面恶化。
HCC的诊断对患者的HRQL有深远的负面影响。心理健康成分随时间显著恶化。在多学科HCC护理模式中纳入心理健康服务的必要性显而易见。
