Health-Related Quality of Life in Patients with Hepatocellular Carcinoma Treated with Initial Transarterial Chemoembolization
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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.
KeywordsTACE HCC HRQLQ-HCC18 EORTC Patient-tailored treatment
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
Society of Interventional Radiology
Selective internal radiotherapy
Radio frequency ablation
- DEB TACE
Drug-eluting beads TACE
This study was supported by a Grant from the ART (Arbeitsgemeinschaft Regionale Tumortherapie; German workforce for regional tumour therapy).
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 was obtained from all individual participants included in the study.
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