Health-Related Quality of Life before and after Surgical Resection of Hepatocellular Carcinoma: A Prospective Study
Asian Pacific journal of cancer prevention : APJCP(2018)
Abstract
Background and Objectives: This large-scale prospective cohort study of a Taiwan population applied generalized
estimating equations (GEEs) to evaluate changing trends in health-related quality of life (HRQoL) and to compare
predictors of HRQoL before and after surgical resection of hepatocellular carcinoma (HCC) performed during
2011-2014. Materials and Methods: The Short Form-36 Health Survey (SF-36) and Functional Assessment of Cancer
Therapy-Hepatobiliary were used in a preoperative assessment and in 3- and 6-month postoperative assessments of 332
HCC patients. Results: The HRQoL was signficantly (p<0.05) improved at 3 months after surgical resection of HCC
and plateaued at 6 months after surgery. Scores for both the SF-36 Physical Component Summary (PCS) and Mental
Component Summary (MCS) were significantly higher at the third month after surgery (p<0.05) compared to the
preoperative period. Both scores also exceeded the norms after hepatic resection of HCC. However, PCS scores were
generally higher than MCS scores throughout the study period. After adjusting for time effects and baseline predictors,
GEE approaches revealed the following explanatory variables for HRQoL: time of HRQoL assessment, gender, age,
education, coresidence with family, chemotherapy, average length of hospital stay, and preoperative functional status.
Conclusions: Hepatic resection significantly increased HRQoL in patients with HCC (p<0.05). However, an evaluation
of HRQoL after hepatic resection should consider several factors other than outcomes of the surgery itself. Additionally,
patients should be advised that their HRQoL improvement after surgery might depend not only on the success of surgery,
but also on their preoperative functional status.
MoreTranslated text
Key words
Hepatocellular carcinoma,health-related quality of life,SF−36,FACT-Hep
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