Pain could predict survival of liver cancer patients

Understanding the role of pain hepatocellular carcinoma (HCC) or liver cancer is critical since pain has adverse effects on quality of life and could be a predictor of survival, according to research reported in The Journal of Pain, published by the American Pain Society, www.ampainsoc.org.

Previous studies have established that predictors of survival for primary and metastsatic liver cancer patients include an increase in upper abdominal pain. This study investigated whether pain in its own right might have prognostic significance. The authors examined a database of 3,417 patients with liver cancer who presented with and without pain. A Kaplan-Meier analysis was performed to determine the differences in survival for patients reporting pain and those who did not.

The authors noted that pain is associated with decreased health-related quality of life in cancer patients and also with increased disability and mood disorders. Pain, therefore, is a major component of quality of life evaluations, and diminished quality of life is associated with poorer survival in several tumor types, including HCC.

The data base analysis showed that pain was linked with poorer survival in liver cancer patients who presented with pain vs. those who did not. The mean survival in those with pain was 325 days vs. 498 days for patients who were pain-free. The authors also evaluated the impact of tumor characteristics to determine if they alone could account for the presence of pain and poorer survival rates. They reported that patients with pain had larger and more aggressive tumors and had alphafetaprotien blood levels (a proven poor prognostic factor in liver cancer) that were twice as high as in patients without pain.

The authors concluded that further investigation is needed to determine which quality of life factors are most predictive for survival in liver cancer patients. Whether the treatment of pain can increase quality of life and improve survival outcomes should be explored further in clinical trials.