Quality of Life Research

, 16:389 | Cite as

Quality of life after radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma: comparison with transcatheter arterial chemoembolization alone

  • Yan-Bin Wang
  • Min-Hua Chen
  • Kun Yan
  • Wei Yang
  • Ying Dai
  • Shan-Shan Yin
Article

Abstract

Objective

Comprehensive studies are scarce with regard to the quality of life (QOL) of hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE) and/or radiofrequency ablation (RFA) treatment. The purpose of this study was to examine the impact of TACE alone and that of the TACE followed by RFA (TACE–RFA) on QOL in HCC patients.

Methods

QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G) (Version 4.0) questionnaire, translated into Chinese, as a measure of QOL among Chinese HCC patients. Prospectively, 83 patients in both TACE group (n = 40) and TACE–RFA group (n = 43) completed the questionnaire at baseline and 3 months after treatment, respectively.

Results

The TACE–RFA group resulted in a significantly higher total QOL score, socio-family well-being score, and functional well-being score than that of TACE group, 3 months after respective treatment. Liver function, tumor recurrence and complication, age, income were the most important factors affecting the QOL of HCC patients after treatment. The logistic regression analyses showed that Child-Pugh Class and tumor recurrence after treatment were independent predictors of post-treatment QOL scores of HCC patients.

Conclusions

The overall QOL of HCC patients in TACE–RFA group was maintained at a relatively higher level than that of TACE group. TACE followed by RFA appeared to be more favorable than TACE alone with respect to QOL.

Keywords

Hepatocellular carcinoma Quality of life Radiofrequency ablation Transcatheter arterial chemoembolization 

References

  1. 1.
    Verhoef C, Visser O, de Man RA, de Wilt JH, IJzermans JN, Janssen-Heijnen ML (2004) Hepatocellular carcinoma in the Netherlands incidence, treatment and survival patterns. Eur J Cancer 40(10): 1530–538CrossRefPubMedGoogle Scholar
  2. 2.
    Geschwind JF (2002) Chemoembolization for Hepatocellular Carcinoma: Where does the truth lie? J Vasc Interv Radiol 13(10):991–94CrossRefPubMedGoogle Scholar
  3. 3.
    Garcea G, Lloyd TD, Aylott C, Maddern G, Berry DP (2003) The emergent role of focal liver ablation techniques in the treatment of primary and secondary liver tumors. Eur J Cancer 39(15):2150–164CrossRefPubMedGoogle Scholar
  4. 4.
    Moinpour CM (1994) Measuring quality of life: an emerging science. Semin Oncol 21(5 Suppl 10):48–3PubMedGoogle Scholar
  5. 5.
    Buscarini L, Buscarini E, Di Stasi M (2001) Percutanenous radiofrequncy ablation of small hepatocellular carcinoma: long-term results. Eur Radiol 11(6):914–21CrossRefPubMedGoogle Scholar
  6. 6.
    Ramsey DE, Kernagis LY, Soulen MC, Geschwind JF (2002) Chemoembolization of Hepatocellular Carcinoma. J Vasc Interv Radiol 13(9):S211–S221CrossRefPubMedGoogle Scholar
  7. 7.
    Zhao JB, Li YH, Chen Y, Zeng QL, He XF, Wei ZH, et al. (2002) Evaluation of quality of life before and after interventional therapy in patients with primary hepatocellular carcinoma. Chin J Radiol 36(10):873–76Google Scholar
  8. 8.
    Poon RT, Fan ST, Yu WC, Lam BK, Chan FY, Wong J (2001) A prospective longitudinal study of quality of life after resection of hepatocellular carcinoma. Arch Surgf 136(6):693–99CrossRefGoogle Scholar
  9. 9.
    Chow PK, Tai BC, Tan CK, Machin D, Win KM, Johnson PJ, et al. (2002) High-dose tamoxifen in the treatment of inoperable hepatocellular carcinoma: A multicenter randomized controlled trial. Hepatology 36(5):1221–226CrossRefPubMedGoogle Scholar
  10. 10.
    Chen MH, Yang W, Yan K, Zou MW, Solbiati L, Liu JB, et al. (2004) Large liver tumors: Protocol for radiofrequency ablation and its clinical application in 110 patients—Mathematic model, overlapping mode, and electrode placement process. Radiology 232(1):260–71CrossRefPubMedGoogle Scholar
  11. 11.
    Cheung YB, Thumboo J, Goh C, Khoo KS, Che W, Wee J (2004) The equivalence and difference between the English and Chinese versions of two major, cancer-specific, health-related quality-of-life questionnaires. Cancer 101(12):2874–880CrossRefPubMedGoogle Scholar
  12. 12.
    Yu CL, Fielding R, Chan CL, Tse VK, Choi PH, Lau WH, et al. (2000) Measuring quality of life of Chinese cancer patients: A validation of the Chinese version of the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Cancer 88(7):1715–727CrossRefPubMedGoogle Scholar
  13. 13.
    Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R (1973) Transection of the esophagus for bleeding esoghageal varices. Br J Surg 60(8):646–49CrossRefPubMedGoogle Scholar
  14. 14.
    Higuchi T, Kikuchi M, Okaxaki M (1994) Hepatocellular carcinoma after transcatheter hepatic arterial embolization. A histopathologic study of 84 resected cases. Cancer 73(9):2259–267CrossRefPubMedGoogle Scholar
  15. 15.
    Poon RT, Ngan H, Lo CM, Liu CL, Fan ST, Wong J (2000) Transarterial chemoembolization for inoperable hepatocellular carcinoma and postresection intrahepatic recurrence. J Surg Oncol 73(2):109–14CrossRefPubMedGoogle Scholar
  16. 16.
    Rossi S, Garbagnati F, Lencioni R, Allgaier HP, Marchiano A, Fornari F, et al. (2000) Percutaneous radiofrequncy thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply. Radiology 217(1):119–26PubMedGoogle Scholar
  17. 17.
    Flechtner H, Bottomley A (2003) Fatigue and quality of life: Lessons from the real world. Oncologist Supp l1:5–9CrossRefGoogle Scholar
  18. 18.
    Steineck G, Helgesen F, Adolfsson J, Dickman PW, Johansson JE, Norlen BJ, et al. (2002) Quality of life after radical prostatectomy or watchful waiting. N Engl J Med 347(11):790–96CrossRefPubMedGoogle Scholar
  19. 19.
    Acunas B, Rozanes I (1999) Hepatocellular carcinoma: Treatment with transcatheter arterial chemoembolization. Eur J Radiol 32(1):86–9CrossRefPubMedGoogle Scholar
  20. 20.
    Gates J, Hartnell GG, Stuart KE, Clouse ME (1999) Chemoembolization of hepatic heoplasms: Safety, complications, and when to worry. Radiographics 19(2):399–14PubMedGoogle Scholar
  21. 21.
    Goldberg SN, Ahmed M (2002) Minimally invasive image-guided therapies for hepatocellular carcinoma. J Clin Gsatroenterol 35(Suppl 2):S115–S129CrossRefGoogle Scholar
  22. 22.
    Sharif F, Mohebbi S, Tabatabaee H-R, Saberi-Firoozi M, Gholamzadeh S (2005) Effects of psycho-educational intervention on health-related quality of life (QOL) of patients with chronic liver disease referring to Shiraz University of Medical Sciences. Health Qual Life Outcomes 3:81–7CrossRefPubMedGoogle Scholar
  23. 23.
    Hauser W, Holtmann G, Grandt D (2004) Determinants of health related quality of life in patients with chronic liver diseases. Clin Gastroenterol Hepatol 2(2):157–63CrossRefPubMedGoogle Scholar
  24. 24.
    Llovet JM, Burroughs A, Bruix J (2003) Hepatocellular carcinoma. Lancet 362(9399):1907–917CrossRefPubMedGoogle Scholar
  25. 25.
    Charnsangavej C, Chuang VP, Wallace S, Soo CS, Bowers T (1982) Angiographic classification of hepatic arterial collaterals. Radiology 144(3):485–94PubMedGoogle Scholar
  26. 26.
    Okazaki M, Yamasaki S, Ono H, Higashihara H, Koganemaru F, Kimura S, et al. (1993) Chemoembolotherapy for recurrent hepatocellular carcinoma in the residul liver after hepatectomy. Hepatogastroenterology 40(4):320–23PubMedGoogle Scholar
  27. 27.
    Huang JF, Li SQ, Liang LJ (2000) The effect of transcatheter arterial chemoembolizationin the treatment of hepatocellular carcinoma. Chin J Hepatobiliary Surg 6(1):3–6Google Scholar
  28. 28.
    Takayasu K, Muramatsu Y, Maeda T, Iwata R, Furukawa H, Muramatsu Y, et al. (2001) Targeted transarterial oil chemoembolization for small foci of hepatocellular carcinoma using a unified helical CT and angiography system. AJR Am J Roentgenol 176(3):681–88PubMedGoogle Scholar
  29. 29.
    Solbiati L, Goldberg SN, Ierace T, Ellanoce M, Livraghi T, Gazelle GS (1999) Radio-fraquency ablation of hepatic metastases: postprocedural assessment with a US microbubble contrast agent-early experience. Radiology 211(3):643–49PubMedGoogle Scholar
  30. 30.
    Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Ierace T, Solbiati L, et al. (2000) Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 214(3):761–68PubMedGoogle Scholar
  31. 31.
    Buscarini L, Rossi S (1997) Technology for radiofrequency thermal ablation of liver tumors. Semin Laparosc Sur 4(2):96–01Google Scholar
  32. 32.
    Soni MK, Cella D (2002) Quality of Life and Symptom Measures in Oncology: An Overview. Am J Manag Care 8(18 suppl):S560–S573PubMedGoogle Scholar
  33. 33.
    Buscarini L, Buscarini E, Distasi M, Quaretti P, Zangrandi A (1999) Percutaneous radiofrequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma. Ultraschall Med 20(2):47–3CrossRefPubMedGoogle Scholar
  34. 34.
    Bloomston M, Binitie O, Fraiji E, Murr M, Zervos E, Goldin S, et al. (2002) Transcatheter arterial chemoembolization with or without radiofrequency ablation in the management of patients with advanced hepatic malignancy. Am Surg 68(9):827–31PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Yan-Bin Wang
    • 1
  • Min-Hua Chen
    • 1
  • Kun Yan
    • 1
  • Wei Yang
    • 1
  • Ying Dai
    • 1
  • Shan-Shan Yin
    • 1
  1. 1.Department of Ultrasound, Clinical Oncology InstituteBeijing UniversityBeijingChina

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