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

Abstract

Purpose

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.

Results

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).

Conclusion

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.

Keywords

TACE HCC HRQLQ-HCC18 EORTC Patient-tailored treatment 

Abbreviations

TACE

Transarterial chemoembolization

HCC

Hepatocellular carcinoma

HRQol

Health-related quality of life

EORTC

European Organisation for Research and Treatment of Cancer

RECIST

Response evaluation criteria in solid tumours

WHO

World Health Organization

mRECIST

Modified response evaluation criteria in solid tumours

EASL

European Association for the Study of the Liver

MELD

Model of End Stage Liver Disease

ECOG

Eastern Cooperative Oncology Group

GHS

Global health status

BCLC

Barcelona Clinic Liver Cancer

SD

Standard deviation

CPS

Child–Pugh score

SIR

Society of Interventional Radiology

SIRT

Selective internal radiotherapy

RFA

Radio frequency ablation

DEB TACE

Drug-eluting beads TACE

Notes

Acknowledgements

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
  • 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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