Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Transpl Int. 2022 May 30;35:10404. doi: 10.3389/ti.2022.10404. eCollection 2022.
Liver transplantation (LT) for patients with non-resectable colorectal liver metastases (CRLM) offers improved survival and has gained increased interest internationally the last years. The aim of this study was to describe the health-related quality of life (HRQoL) in patients with non-resectable CRLM receiving LT and how baseline HRQoL factors affect overall survival (OS). HRQoL data in the SECA (SEcondary CAncer) LT cohort was compared to data obtained from colorectal cancer patients starting first-line chemotherapy for metastatic disease in a clinical trial and data from a Norwegian normal population. HRQoL data from the QLQ-C30 questionnaire used in the SECA LT study and the NORDIC- VII study were reported. The relationship between patient-reported symptom burden at baseline and OS was investigated. In the SECA study longitudinal HRQoL assessment was used to describe the time until definitive deterioration as well as mean values at different time points. Patients in the SECA and NORDIC-VII studies reported similar baseline HRQoL. The median time until definitive deterioration in the transplanted patients was estimated to 36 months. In the SECA study appetite loss and pain at baseline had negative impact on OS (25.3 versus 71.7 months, = 0.002 and 39.7 versus 71.7 months, = 0.038, respectively). Despite a relapse in most of the LT patients the Global Health Score (GHS) remained good. Pain, and especially appetite loss at time of transplantation is associated with poor outcome after LT.
肝移植(LT)可提高无法切除的结直肠癌肝转移(CRLM)患者的生存率,近年来在国际上受到越来越多的关注。本研究旨在描述接受 LT 的无法切除的 CRLM 患者的健康相关生活质量(HRQoL),以及基线 HRQoL 因素如何影响总生存(OS)。在 SECA(继发性癌症)LT 队列中比较了 HRQoL 数据,该队列数据来自接受一线化疗转移性疾病的结直肠癌患者的临床试验数据和挪威正常人群的数据。报告了 SECA LT 研究和 NORDIC-VII 研究中使用的 QLQ-C30 问卷的 HRQoL 数据。研究了基线时患者报告的症状负担与 OS 之间的关系。在 SECA 研究中,使用纵向 HRQoL 评估来描述从最初恶化到不同时间点的平均时间。SECA 和 NORDIC-VII 研究中的患者报告的基线 HRQoL 相似。移植患者的中位时间估计为 36 个月。在 SECA 研究中,基线时的食欲丧失和疼痛对 OS 有负面影响(25.3 与 71.7 个月, = 0.002 和 39.7 与 71.7 个月, = 0.038)。尽管大多数 LT 患者都出现了复发,但全球健康评分(GHS)仍然良好。移植时的疼痛,特别是食欲丧失,与 LT 后不良预后相关。