Frailty assessment in patients with HCC
Research type
Research Study
Full title
Assessment of Frailty in patients with advanced Hepatocellular Cancer
IRAS ID
132791
Contact name
Ruth Plummer
Contact email
Research summary
Hepatocellular cancer (HCC) is increasing in incidence in the UK. For patients with advanced disease two palliative treatment options have, in randomised trials, demonstrated a survival advantage: Transarterial Chemoembolisation (TACE) and drug treatment with Sorafenib.
In our practice in the North East of England the majority of patients with HCC have underlying liver disease secondary to either Non Alcoholic Fatty Liver Disease (NAFLD) or alcohol related cirrhosis and the median age of patients referred to our unit is 70. In contrast, patients included in the trials on which the evidence for treatment is based were highly selected, younger and with less co-morbidities. This makes decisions regarding treatment for our patients difficult. Do our patients get the same benefit/toxicity from treatment?
Oncologists recognise that there are some patients who are seemingly fit for treatment but for whom toxicity results in a significant deterioration in functional ability and quality of life which in some situations is not regained. These patients are probably frail. We currently make subjective decisions about frailty and as a result sometimes modify standard treatment regimens.
We want to assess the feasibility of assessing frailty in patients prior to, during and after planned treatment for their advanced HCC, with the aim of evaluating whether we can find objective ways of identifying patients who are likely to get palliative benefit from treatment.
We are inviting patients from the oncology and hepatology clinics for whom a management plan has already been decided, to participate in the study and have a multifactorial assessment of their fitness. It will involve meeting with a member of the research team to have an assessment of frailty, nutritional status and comorbidities before, during and after the planned treatment. In addition patients will be asked to complete quality of life questionnaires.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
13/NE/0264
Date of REC Opinion
1 Oct 2013
REC opinion
Favourable Opinion