Quality of Life Research

, 17:831 | Cite as

Quality of life as a prognostic factor of overall survival in patients with advanced hepatocellular carcinoma: results from two French clinical trials

  • Franck Bonnetain
  • Xavier Paoletti
  • Sandra Collette
  • Michel Doffoel
  • Olivia Bouché
  • Jean Luc Raoul
  • Philippe Rougier
  • Fadil Masskouri
  • Jean Claude Barbare
  • Laurent Bedenne



The aims of our study were to assess quality of life (QoL) as a prognostic factor of overall survival (OS) and to determine whether QoL data improved three prognostic classifications among French patients with advanced hepatocellular carcinoma (HCC).


Among 538 included patients, QoL at baseline was available for 489 patients (90%). Longer median OS was significantly associated with higher Spitzer scores at baseline, ranging from 2.17 months (Spitzer = 3) to 8.93 months (Spitzer = 10). Variables retained in the multivariate Cox model were: jaundice, hepatomegaly, hepatalgia, portal thrombosis, alphafetoprotein, bilirubin, albumin, small HCC, and Spitzer QoL Index (hazard ratio = 0.84 95% CI [0.79–0.90]). According to Harrell’s C-index, QoL was the best prognostic variable to add. CLIP plus the Spitzer QoL Index had the most discriminating value (C = 0.71).


Our results suggest that QoL is an independent prognostic factor for survival in HCC patients with mainly alcoholic cirrhosis. The prognostic value of CLIP score could be improved by adding Spitzer QOL Index scores.


Quality of life Hepatocellular carcinoma Prognostic factor Overall survival Validation 


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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Franck Bonnetain
    • 1
    • 2
  • Xavier Paoletti
    • 3
  • Sandra Collette
    • 3
  • Michel Doffoel
    • 4
  • Olivia Bouché
    • 5
  • Jean Luc Raoul
    • 6
  • Philippe Rougier
    • 7
  • Fadil Masskouri
    • 1
  • Jean Claude Barbare
    • 8
  • Laurent Bedenne
    • 7
  1. 1.Methodological and Biostatistical unitFédération Francophone de Cancérologie Digestive, INSERM U866DijonFrance
  2. 2.Centre Georges François LeclercDijon cedexFrance
  3. 3.Institut National du CancerParisFrance
  4. 4.CHU StrasbourgStrasbourg cedexFrance
  5. 5.Service d’HépatogastroentérologieCentre Hospitalo-Universitaire R. DebréReimsFrance
  6. 6.Centre Eugène MarquisRennesFrance
  7. 7.Fédération Francophone de Cancérologie Digestive, INSERM U866DijonFrance
  8. 8.Division à la recherche CliniqueCHU Amiens NordAmiensFrance

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