Abstract: Objective To analyze the status quo and influencing factors of the quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy, and to provide evidence for improving quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy. Methods A total of 211 patients with intermediate and advanced liver cancer who received immunotherapy in the Guangxi Medical University Cancer Hospital from January 2022 to July 2023 were selected as the study objects. A cross⁃sectional investigation was conducted with general data questionnaire, hospital anxiety and depression scale (HADS), functional assessment of cancer therapy⁃hepatobiliary questionnaire (FACT⁃Hep). Multiple linear regression was used to analyze the influencing factors of quality of life. Results The total score of quality of life in patients with intermediate and advanced liver cancer treated by immunotherapy was (130.04±15.28). Multiple linear regression analysis showed that HADS⁃D>7 score (β=-10.257, 95%CI:  -14.862, -5.653) and previous hepatectomy (β=-8.484, 95%CI: -12.765, -4.203) were the influencing factors of poor total quality of life. HADS⁃A>7 score (β=-2.273, 95%CI: -3.866, -0.681), previous hepatectomy (β=-2.500, 95%CI: -3.825, -1.174) were the influencing factors of the poor score of physical condition; and secondary school education level (β=2.574, 95%CI: 0.862, 4.286), TACE/HAIC (β=1.746, 95%CI: 0.010, 3.482) were the influencing factors of the better score of physical condition. Monthly family income was 4,000-5,999 yuan (β=-2.357, 95%CI: -4.429, -0.284), HADS⁃D>7 score (β=-1.182, 95%CI: -1.992, -0.372) were the influencing factor of poor score of social/family status. HADS⁃D>7 score (β=-3.422, 95%CI: -4.276, -2.568) was the influencing factor of the poor score of psychological status; and multiple tumors score (β=1.053, 95%CI: 0.131, 1.975) was the influencing factor of the better score of psychological status. HADS⁃D>7 score (β=-2.483, 95%CI: -3.526, -1.440) was the influencing factor of the poor score of functional status. Previous hepatectomy (β=-4.255, 95%CI: -6.560, -1.951) was the influencing factor of the poor score of hepatobiliary specific status dimension; and TACE/HAIC (β=3.555, 95%CI: 0.590, 6.520) was the influencing factor of the better score of hepatobiliary specific status dimension. Conclusions The overall health status of patients with intermediate and advanced liver cancer treated by immunotherapy is poor. It is necessary to pay attention to patients with low education level, low monthly family income, combined therapy, and heavy disease and psychological burden, and effective individualized programs should be formulated and implemented to improve the quality of life.

Key words: Liver cancer, Immunotherapy, Quality of life, Influencing factor