Guangxi Medical University Cancer Hospital, Nanning, China.
Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
Support Care Cancer. 2024 Aug 14;32(9):589. doi: 10.1007/s00520-024-08790-y.
To assess the independent and combined associations of tumor-related psychiatric symptoms (TRPS) with dynamic health-related quality of life (HRQL) in patients with hepatocellular carcinoma (HCC) after hepatectomy and to identify related patterns of health behaviors.
This prospective study included patients with HCC who underwent hepatectomy between September 2021 and May 2022. Independent and combined associations between TRPS and HRQL were identified by generalized linear model and weighted quantile sum model, respectively. Trajectories of HRQL were identified by latent class mixed model.
Among the 205 patients, 174 (84.9%) were male. For the outcome of HRQL at 6 months: Anxiety, depression, fatigue, and sleep disorder were independently associated with a decrease of HRQL (all P < 0.05). A negative combined effect of TRPS was also found (β = - 5.07, 95% CI, - 10.01 to - 0.13), with depression emerged as the predominant contributor (49%). The health behaviors of body mass index, smoking, drinking, or physical exercise were not significantly modified the associations between combined TRPS and HRQL (all P > 0.05 for interaction). Similar results were also found for the HRQL at baseline and at 1 and 3 months. Three HRQL trajectory groups were identified: recover (44.9%), poor (44.4%), and deteriorating (10.7%). Deteriorating group was associated with higher incidence of TRPS (all P < 0.05).
TRPS were associated with a decrease of HRQL regardless of healthy behaviors in HCC patients. Therefore, healthy behaviors promotion alone might not substantially increase HRQL associated with TRPS, and other measures tackling TRPS are warranted.
评估肝癌（HCC）患者肝切除术后肿瘤相关精神症状（TRPS）与动态健康相关生活质量（HRQL）的独立和联合关联，并确定相关健康行为模式。
本前瞻性研究纳入了 2021 年 9 月至 2022 年 5 月期间接受肝切除术的 HCC 患者。采用广义线性模型和加权分位数和模型分别确定 TRPS 与 HRQL 的独立和联合关联。采用潜在类别混合模型确定 HRQL 轨迹。
在 205 名患者中，174 名（84.9%）为男性。对于 6 个月时的 HRQL 结局：焦虑、抑郁、疲劳和睡眠障碍与 HRQL 下降独立相关（均 P<0.05）。还发现 TRPS 的负面综合效应（β= −5.07，95%CI，−10.01 至−0.13），其中抑郁是主要贡献者（49%）。体重指数、吸烟、饮酒或体育锻炼等健康行为对 TRPS 与 HRQL 之间的关联没有显著改变（交互作用的所有 P 值均>0.05）。在基线、1 个月和 3 个月时的 HRQL 也发现了类似的结果。确定了 3 个 HRQL 轨迹组：恢复（44.9%）、较差（44.4%）和恶化（10.7%）。恶化组与 TRPS 发生率较高相关（均 P<0.05）。
TRPS 与 HCC 患者 HRQL 下降相关，无论健康行为如何。因此，仅促进健康行为可能不会显著增加与 TRPS 相关的 HRQL，需要采取其他措施来解决 TRPS。
