Results

Baseline Characteristics

The study included 163 male patients and 19 female patients. Baseline data are shown in Table 1. Their average age was 56.01 years (range: 35–81 years). The patients included 147 cases of viral hepatitis B and 3 cases of viral hepatitis C. Premedication: 93 patients with liver transplantation or hepatectomy, 64 patients with TACE, 13 patients with ablation, and 12 patients with direct oral medication. There were 162 cases of Child-Pugh grade A and 20 cases of Child-Pugh grade B. ECOG PS 0–1163 cases (89.6%), ECOG PS score 0–1 was 126 (69.2%) in patients 1 month after taking the drug.

Table 1

According to the multivariate analysis results in Table 2, fatigue is an independent risk factor for HCC patients taking.


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Table 2

Survival Analysis

The OS and TTP analysis of the patients in this group were analyzed by Kaplan–Meier method, and Figure 1 is obtained. As can be seen from Figure 1, the median OS for this group of patients was 19.5 months (95% Cl: 16.48–22.53), and the median TTP was 10.7 months (95% Cl: 9.14–12.26) (Table 2). Fatigue is an independent risk factor for the survival of patients with advanced hepatocellular carcinoma treated with sorafenib (P<0.009).

Figure 1

Fatigue

To better study the effects of fatigue on this group of patients, we divided patients into fatigue grade I (n=74), fatigue grade II (n=62), and fatigue grade III (n=46) according to NCI CTCAE version 5.0.17 (Table 3). The following statistics were performed on the baseline data of the grouped patients, as shown in Table 4.

Table 3

Table 4

(To see a larger version of Table 4, click here.)

After the patients were divided into three groups according to the fatigue level, the overall survival time (OS) and time to disease progression (TTP) analysis of the patients after grouping were analyzed by Kaplan–Meier method, and Figure 2 is obtained.

Figure 2

OS and TTP

The median follow-up time of the overall survival for patients with grade I, II, and III fatigue was 33.0 months, 18.3 months, and 10.1 months (P<0.000), with OS time for grade I and II patients. Statistically significant (χ2 = 25.069; P<0.000). The OS time of grade I and III patients was statistically significant (χ2 = 59.272; P<0.000), and the OS time of grade II and III patients was also statistically significant (χ2 =10.667; P=0.001). In the time course of disease progression, the median follow-up time for patients with grade I, II, and III fatigue was 20.3, 10.0, and 6.2 months (P<0.000), with grade I and grade II patients. The TTP was statistically significant (χ2 = 21.606; P<0.000). The TTP of patients with grade I and III fatigue was statistically significant (χ2 = 39.931; P<0.000). The TTP of patients with grade II and III fatigue was also statistically significant (χ2 = 5.861; P = 0.015).

Patients with grade II and III fatigue were combined and compared with those with grade I fatigue, and the results are presented in Figures 3 and 4.

Figure 3

Figure 4

The results indicated that fatigue that can be relieved by resting had an important effect on the overall survival time of patients and on time to disease progression. We analyzed the patients after regrouping and the results are shown in Table 5.

Table 5

(To see a larger version of Table 5, click here.)

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