CardioVascular and Interventional Radiology

, Volume 40, Issue 10, pp 1559–1566 | Cite as

Health-Related Quality of Life in Patients with Hepatocellular Carcinoma Treated with Initial Transarterial Chemoembolization

  • Jan B. HinrichsEmail author
  • Davut B. Hasdemir
  • Maximilian Nordlohne
  • Nora Schweitzer
  • Frank Wacker
  • Arndt Vogel
  • Martha M. Kirstein
  • Steffen Marquardt
  • Thomas Rodt
Clinical Investigation



To investigate the impact of the first transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) on health-related quality of life (HRQoL) and identify predictors for low HRQoL following TACE.

Materials and Methods

HRQoL was prospectively evaluated in 79 patients with standardized questionnaires (QlQ-C30 and HCC18) pre- and 2 weeks post-TACE. Treatment response was evaluated using common tumour response criteria. Clinical parameters [e.g. Eastern Cooperative Oncology Group (ECOG) performance status, Model of End Stage Liver Disease (MELD) score], tumour load and pre-TACE HRQoL scores were tested for predicting HRQoL after TACE.


Patients showed a 12.1% decrease in global health score (GHS). Major decreases were observed for physical (−21.4%), role (−23.4%), and social (−21.5%) functioning and increases in symptom severity for fatigue (+30.1%), loss of appetite (+25.3%), pain (+19.4%) after TACE. ECOG performance status >1 was associated with increased nausea/vomiting (p = 0.002) and decreased GHS (p = 0.01). MELD score >10 was associated with increased fatigue (p = 0.021) and abdominal swelling (p < 0.001). Our study showed an increase in symptom severity in patients with no symptoms before TACE for pain (p = 0.005) and abdominal swelling (p < 0.001).


The first TACE for treatment of HCC does not result in a major loss of HRQoL in general. For TACE as a palliative therapy maintaining HRQoL is of critical importance and standardized HRQoL assessment can help to detect HRQoL problems.


TACE HCC HRQLQ-HCC18 EORTC Patient-tailored treatment 



Transarterial chemoembolization


Hepatocellular carcinoma


Health-related quality of life


European Organisation for Research and Treatment of Cancer


Response evaluation criteria in solid tumours


World Health Organization


Modified response evaluation criteria in solid tumours


European Association for the Study of the Liver


Model of End Stage Liver Disease


Eastern Cooperative Oncology Group


Global health status


Barcelona Clinic Liver Cancer


Standard deviation


Child–Pugh score


Society of Interventional Radiology


Selective internal radiotherapy


Radio frequency ablation


Drug-eluting beads TACE



This study was supported by a Grant from the ART (Arbeitsgemeinschaft Regionale Tumortherapie; German workforce for regional tumour therapy).

Author's Contribution

JBH and DBH: Conception, acquisition of data, draft, interpretation, MN and NS: Acquisition of data, FW: Revision, conception, draft, AV: Revision, MMK: Major Revision CVIR clinical part, SM: Major Revision CVIR radiological part, TR: Conception, interpretation, draft, revision.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Jan B. Hinrichs
    • 1
    Email author
  • Davut B. Hasdemir
    • 1
  • Maximilian Nordlohne
    • 1
  • Nora Schweitzer
    • 2
  • Frank Wacker
    • 1
  • Arndt Vogel
    • 2
  • Martha M. Kirstein
    • 2
  • Steffen Marquardt
    • 1
  • Thomas Rodt
    • 1
  1. 1.Institute for Diagnostic and Interventional RadiologyMedical School HannoverHannoverGermany
  2. 2.Department of Gastroenterology, Hepatology and EndocrinologyMedical School HannoverHannoverGermany

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