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Long-Term Quality of Life After Hepatic Resection: Health Is not Simply the Absence of Disease

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Abstract

Background

Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and health in patients requiring hepatic surgery for benign or malignant disease.

Methods

QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and the liver-specific QLQ-LMC21 module.

Results

Between 2002 and 2006, 249 patients underwent hepatic surgery for malignant (76%) and benign (24%) conditions. One hundred thirty-five patients were available for QoL analysis after a mean of 26.5 months. There was no statistical difference in global QoL scores between patients with malignant and benign diseases (p = 0.367). Neither the extent of the resection (≥2 segments vs. <2 segments; p = 0.975; OR = 0.988; 95% CI = 0.461–2.119) nor patient age had a significant influence on overall QoL (p = 0.092).

Conclusions

These results indicate that long-term QoL for patients who underwent liver resection for malignant disease is quite good and that a poor clinical prognosis does not seem to correlate with a poor QoL.

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References

  1. Cella DF (1994) Quality of life: concepts and definition. J Pain Symptom Manage 9:186–192

    Article  PubMed  CAS  Google Scholar 

  2. Lopez ED, Eng E, Randall-David E et al (2005) Quality-of-life concerns of African American breast cancer survivors within rural North Carolina: blending the techniques of photovoice and grounded theory. Qual Health Res 15:99–115

    Article  PubMed  Google Scholar 

  3. Dorval M, Maunsell E, Deschenes L et al (1998) Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol 16:487–494

    PubMed  CAS  Google Scholar 

  4. Vinokur AD, Threatt BA, Caplan RD et al (1989) Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening population. Cancer 63:394–405

    Article  PubMed  CAS  Google Scholar 

  5. Chun YS, Vauthey JN, Ribero D et al (2007) Systemic chemotherapy and two-stage hepatectomy for extensive bilateral colorectal liver metastases: perioperative safety and survival. J Gastrointest Surg 11:1498–1504

    Article  PubMed  Google Scholar 

  6. Schiesser M, Chen JW, Maddern GJ et al (2007) Perioperative morbidity affects long-term survival in patients following liver resection for colorectal metastases. J Gastrointest Surg 12:1054–1060

    Article  PubMed  Google Scholar 

  7. Capussotti L, Polastri R (1998) Operative risks of major hepatic resections. Hepatogastroenterology 45:184–190

    PubMed  CAS  Google Scholar 

  8. Nuzzo G, Giuliante F, Ardito F et al (2008) Influence of surgical margin on type of recurrence after liver resection for colorectal metastases: a single-center experience. Surgery 143:384–393

    Article  PubMed  Google Scholar 

  9. Wakai T, Shirai Y, Tsuchiya Y et al (2008) Combined major hepatectomy and pancreaticoduodenectomy for locally advanced biliary carcinoma: long-term results. World J Surg 32:1061–1074

    Article  Google Scholar 

  10. Elias D, Benizri E, Pocard M et al (2006) Treatment of synchronous peritoneal carcinomatosis and liver metastases from colorectal cancer. Eur J Surg Oncol 32:632–636

    Article  PubMed  CAS  Google Scholar 

  11. Adam R, Delvart V, Pascal G et al (2004) Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 240:644–657

    Article  PubMed  Google Scholar 

  12. Menon KV, Al-Mukhtar A, Aldouri A et al (2006) Outcomes after major hepatectomy in elderly patients. J Am Coll Surg 203(5):677–683

    Article  PubMed  Google Scholar 

  13. Hanazaki K, Kajikawa S, Shimozawa N et al (2001) Hepatic resection for hepatocellular carcinoma in the elderly. J Am Coll Surg 192:38–46

    Article  PubMed  CAS  Google Scholar 

  14. Mazzoni G, Tocchi A, Miccini M et al (2007) Surgical treatment of liver metastases from colorectal cancer in elderly patients. Int J Colorectal Dis 22:77–83

    Article  PubMed  Google Scholar 

  15. Ng KK, Vauthey JN, Pawlik TM et al (2005) Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multi-institutional database. Ann Surg Oncol 12:364–373

    Article  PubMed  Google Scholar 

  16. Fan ST, Ng IO, Poon RT et al (1999) Hepatectomy for hepatocellular carcinoma: the surgeon’s role in long-term survival. Arch Surg 134(10):1124–1130

    Article  PubMed  CAS  Google Scholar 

  17. Neuhaus P, Jonas S, Bechstein WO et al (1999) Extended resections for hilar cholangiocarcinoma. Ann Surg 230:808–818

    Article  PubMed  CAS  Google Scholar 

  18. Jarnagin WR, Fong Y, DeMatteo RP et al (2001) Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Ann Surg 234:507–517

    Article  PubMed  CAS  Google Scholar 

  19. Mann CD, Neal CP, Pattenden CJ et al (2008) Major resection of hepatic colorectal liver metastases in elderly patients—an aggressive approach is justified. Eur J Surg Oncol 34:428–432

    PubMed  CAS  Google Scholar 

  20. Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318

    Article  PubMed  CAS  Google Scholar 

  21. Nuzzo G, Giuliante F, Ardito F et al (2007) Liver resection for primarily unresectable colorectal metastases downsized by chemotherapy. J Gastrointest Surg 11:318–324

    Article  PubMed  Google Scholar 

  22. Slevin ML (1992) Quality of life: philosophical question or clinical reality? BMJ 305:466–469

    Article  PubMed  CAS  Google Scholar 

  23. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  PubMed  CAS  Google Scholar 

  24. Kavadas V, Blazeby JM, Conroy T et al (2003) Development of an EORTC disease-specific quality of life questionnaire for use in patients with liver metastases from colorectal cancer. Eur J Cancer 39:1259–1263

    Article  PubMed  CAS  Google Scholar 

  25. Couinaud C (1956) Contribution of anatomical research to liver surgery. Fr Med 19:5–12

    PubMed  CAS  Google Scholar 

  26. Kondo Y, Yoshida H, Tateishi R et al (2007) Health-related quality of life of chronic liver disease patients with and without hepatocellular carcinoma. J Gastroenterol Hepatol 22:197–203

    Article  PubMed  Google Scholar 

  27. Sloan JA, Loprinzi CL, Kuross SA et al (1998) Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol 16:3662–3673

    PubMed  CAS  Google Scholar 

  28. Glimelius B, Hoffman K, Graf W et al (1994) Quality of life during chemotherapy in patients with symptomatic advanced colorectal cancer. The Nordic Gastrointestinal Tumor Adjuvant Therapy Group. Cancer 73:556–562

    Article  PubMed  CAS  Google Scholar 

  29. Sterkenburg CA, King B, Woodward CA (1996) A reliability and validity study of the McMaster Quality of Life Scale (MQLS) for a palliative population. J Palliat Care 12:18–25

    PubMed  CAS  Google Scholar 

  30. Brunelli C, Costantini M, Di Giulio P et al (1998) Quality-of-life evaluation: when do terminal cancer patients and health-care providers agree? J Pain Symptom Manage 15:151–158

    Article  PubMed  CAS  Google Scholar 

  31. Slevin ML, Stubbs L, Plant HJ et al (1990) Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. BMJ 300:1458–1460

    Article  PubMed  CAS  Google Scholar 

  32. Perez DJ, McGee R, Campbell AV et al (1997) A comparison of time trade-off and quality of life measures in patients with advanced cancer. Qual Life Res 6:133–138

    Article  PubMed  CAS  Google Scholar 

  33. Martin RC, Eid S, Scoggins CR et al (2007) Health-related quality of life: return to baseline after major and minor liver resection. Surgery 142:676–684

    Article  PubMed  Google Scholar 

  34. Chen L, Liu Y, Li GG et al (2004) Quality of life in patients with liver cancer after operation: a 2-year follow-up study. Hepatobiliary Pancreat Dis Int 3:530–533

    PubMed  Google Scholar 

  35. Fletcher AE, Bulpitt CJ (1988) Measurement of quality of life in clinical trials of therapy. Cardiology 75(Suppl 1):41–52

    Article  PubMed  Google Scholar 

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Correspondence to Daniel Candinas.

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Banz, V.M., Inderbitzin, D., Fankhauser, R. et al. Long-Term Quality of Life After Hepatic Resection: Health Is not Simply the Absence of Disease. World J Surg 33, 1473–1480 (2009). https://doi.org/10.1007/s00268-009-0032-4

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