Prevalence and its associated factors of cancer-related fatigue among liver cancer patients: a cross-sectional study

This study aimed to identify the prevalence of CRF and its associated factors in liver cancer patients. A cross-sectional study was conducted at a major teaching hospital in Sichuan Province, China, between October and December 2025. A total of 315 liver cancer patients were recruited to complete a survey comprising the demographic and clinical information form, the Cancer Fatigue Scale (CFS), the FRAIL Scale, the Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and binary logistic regression were employed to determine the factors associated with CRF. Among 315 liver cancer patients, 206 (65.4%) participants were diagnosed with CRF. BCLC stage (A: OR = 2.050, 95% CI: 0.889-4.727, P = 0.092; B: OR = 2.921, 95% CI: 1.260-6.772, P = 0.012; C: OR = 5.247, 95% CI: 2.094-13.150, P < 0.001; D: OR = 7.334, 95% CI: 1.300-41.389, P = 0.024), chemotherapy history (OR = 2.202, 95% CI: 1.153-4.197, P = 0.017), physical frailty (OR = 3.343, 95% CI: 1.880-5.946, P < 0.001), depression (OR = 1.133, 95% CI: 1.063-1.208, P < 0.001), and the PSQI score (OR = 1.278, 95% CI: 1.172-1.394, P < 0.001) were identified as significantly associated factors of CRF in liver cancer patients in the binary logistic regression analysis. CRF was highly prevalent among liver cancer patients and was significantly associated with BCLC stage, chemotherapy history, physical frailty, depression, and PSQI score. Healthcare professionals should consider these critical factors when assessing and managing CRF in liver cancer patients.