This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (21)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Quality of Life  • Hepatobiliary Surgery  • Alert me on articles by topic  Social Bookmarking   What's this?

Ronnie Tung-Ping Poon, MS,FRCS(Edin); Sheung Tat Fan, MS,MD,FRCS(Glasg),FRCS(Edin); Wun Ching Yu, MBBS; Banny Ka-Yiu Lam, BSc; Flora Yue-Sin Chan, RN,BSc; John Wong, PhD,FRACS

Arch Surg. 2001;136:693-699.

Hypothesis  Hepatic resection improves quality of life (QOL) in patients with resectable hepatocellular carcinoma (HCC).

Design  A prospective longitudinal study.

Setting  A university teaching hospital.

Patients  Sixty-six consecutive patients undergoing resection of HCC, and 10 patients with unresectable HCC found after surgical exploration who were subsequently treated with transarterial chemoembolization (control group).

Main Outcome Measure  Serial measurements of preoperative and postoperative QOL using the Functional Assessment of Cancer Therapy–General (FACT-G) Questionnaire for up to 2 years after surgery (at 3, 6, 9, 12, 18, and 24 months).

Results  Among the 66 patients with resectable HCC, the mean postoperative QOL scores at 3 months after surgery were significantly higher than the mean preoperative QOL scores in domains related to physical, social, and emotional well-being and relationship with physicians. The mean total QOL score increased from 83.5 (SD, 9.4) before surgery to 94.1 (SD, 7.7) at 3 months after surgery (P<.001). No significant change of QOL scores at 3 months after surgery was observed in the control group. Twenty patients in the resected group died of early recurrence within 2 years after surgery, but their mean postoperative QOL scores remained higher than the preoperative QOL scores for most assessment times. In contrast, in the control group, the mean total QOL scores became significantly lower than the preoperative scores, starting 9 months after surgery. Forty-six patients in the resected group completed all QOL assessments. At all postoperative assessments, their mean QOL scores were higher than preoperative scores. Recurrence developed in 13 of the 46 patients within the 2-year study, and there was significant deterioration of QOL over time among these 13 (P<.001), whereas no significant change in QOL over time was observed among the 33 recurrence-free patients. Of various clinicopathologic factors, only advanced pTNM stage was significantly predictive of deterioration of QOL over time after resection of HCC.

Conclusions  Hepatic resection results in significant enhancement of QOL in patients with HCC. Development of recurrence is the main factor leading to deterioration in QOL over time after resection of HCC.

From the Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Health-Related Quality of Life Measurement in Randomized Clinical Trials in Surgical Oncology
Blazeby et al.
JCO 2006;24:3178-3186.
ABSTRACT | FULL TEXT