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Effect of specialized nursing intervention on the prognosis of hepatocellular carcinoma patients treated with sorafenib

Objective: A retrospective study was performed to explore the survival impact of specialized nursing care on hepatocellular carcinoma (HCC) patients receiving sorafenib therapy.

Methods: Patients with and without nursing interventions were divided into two groups. The difference in baseline characteristics and overall survival (OS) were compared between groups and prognostic factors were explored. The specialized nursing interventions consisted of education regarding selfmonitoring and adverse events management.

Results: Out of 89 patients enrolled in this study, 46 patients (51.7%, Group 1) received nursing care and 43 patients (48.3%, Group 2) did not according to the treating departments, hepatobiliary surgery and radiologic intervention, respectively. The median OS of all patients was 21.0 months (95% CI=13.7-28.3). Multivariate analysis revealed that patients without nursing care (RR=2.374, P=0.032) and pre-treatment ECOG performance score (ECOG PS) 2 (RR=6.495, P=0.001) were independent significant predictors for worse prognosis in HCC patients on sorafenib therapy. In patients with ECOG PS less than 2, the median OS of patients in Group 1 was higher than those in group 2 (38.1 months vs. 16.1 months, P=0.01).

Conclusion: Patients with pre-treatment ECOG PS 2 and those without specialized nursing interventions are independent risk factors for poor survival outcomes of advanced HCC patients receiving sorafenib therapy. Specialized nursing care may improve the prognosis of HCC patients, especially those with better ECOG PS.

Author(s): Xufeng Pang, Guizhi Li, Yaqing Lv, Juanjuan Wang, Lili Wei