Skip to main content

Advertisement

SpringerLink
Log in

Quality of life changes in patients undergoing treatment for hepatocellular carcinoma

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. One of the primary treatment goals for incurable advanced cases is to prolong quality of life (QoL). Thus, to determine which HCC therapies may be linked to a more favorable QoL, we assessed the association between QoL changes and different treatments in HCC patients.

Methods

We analyzed a non-randomized multicenter longitudinal study, which included 171 patients treated with surgery (n = 53), ablation (n = 53) or embolization (n = 65) from seven centers: four Asian and three European sites. All participants completed the EORTC QLQ-C30 and QLQ-HCC18 questionnaires before and after treatment. Propensity scores were calculated and used in addition to race for adjustment in the logistic regression model to account for the confounding effects of patient characteristics including age, gender, race, employment, living with family, at least one comorbid condition, years since diagnosis, prior treatment history, BCLC stage, Child–Pugh grade, cirrhosis, bilirubin levels and QoL score before treatment.

Results

After adjustment for confounders, patients tended to have higher odds of QoL deterioration when treated with ablation versus embolization (dyspnea: p = 0.019; appetite loss: p = 0.018; body image: p = 0.035) or ablation versus surgery (dyspnea: p = 0.099; appetite loss: p = 0.100; body image: p = 0.038).

Conclusions

There were significant differences in QoL deterioration across different treatment groups. This information may assist patients and providers when selecting patient-centered treatment approaches for HCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Maluccio, M., & Covey, A. (2012). Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma. CA: A Cancer Journal for Clinicians, 62(6), 394–399.

    Google Scholar 

  2. Venook, A. P., Papandreou, C., Furuse, J., & de Guevara, L. L. (2010). The incidence and epidemiology of hepatocellular carcinoma: A global and regional perspective. Oncologist, 15(Suppl 4), 5–13.

    Article  PubMed  Google Scholar 

  3. Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: A Cancer Journal for Clinicians, 61(2), 69–90.

    Google Scholar 

  4. Greten, T. F., Papendorf, F., Bleck, J. S., Kirchhoff, T., Wohlberedt, T., Kubicka, S., et al. (2005). Survival rate in patients with hepatocellular carcinoma: A retrospective analysis of 389 patients. British Journal of Cancer, 92(10), 1862–1868.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Moinpour, C. M. (1994). Measuring quality of life: An emerging science. Seminars in Oncology, 21(5 Suppl 10), 48–60.

    CAS  PubMed  Google Scholar 

  6. Wang, Y. B., Chen, M. H., Yan, K., Yang, W., Dai, Y., & Yin, S. S. (2007). Quality of life after radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma: Comparison with transcatheter arterial chemoembolization alone. Quality of Life Research, 16(3), 389–397.

    Article  PubMed  Google Scholar 

  7. Lee, L. J., Chen, C. H., Yao, G., Chung, C. W., Sheu, J. C., Lee, P. H., et al. (2007). Quality of life in patients with hepatocellular carcinoma received surgical resection. Journal of Surgical Oncology, 95(1), 34–39.

    Article  PubMed  Google Scholar 

  8. Qiao, C. X., Zhai, X. F., Ling, C. Q., Lang, Q. B., Dong, H. J., Liu, Q., & Li, M. D. (2012). Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma. World Journal of Gastroenterology, 18(21), 2689–2694.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Slevin, M. L. (1992). Quality of life: Philosophical question or clinical reality? British Medical Journal, 305(6851), 466–469.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Bruns, H., Kratschmer, K., Hinz, U., Brechtel, A., Keller, M., Buchler, M. W., & Schemmer, P. (2010). Quality of life after curative liver resection: A single center analysis. World Journal of Gastroenterology, 16(19), 2388–2395.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Poon, R. T., Fan, S. T., Yu, W. C., Lam, B. K., Chan, F. Y., & Wong, J. (2001). A prospective longitudinal study of quality of life after resection of hepatocellular carcinoma. Archives of Surgery, 136(6), 693–699.

    Article  CAS  PubMed  Google Scholar 

  12. Toro, A., Pulvirenti, E., Palermo, F., & Di Carlo, I. (2012). Health-related quality of life in patients with hepatocellular carcinoma after hepatic resection, transcatheter arterial chemoembolization, radiofrequency ablation or no treatment. Surgical Oncology, 21(1), e23–e30. doi:10.1016/j.suronc.2011.10.005.

    Article  PubMed  Google Scholar 

  13. Blazeby, J. M., Currie, E., Zee, B. C., Chie, W. C., Poon, R. T., & Garden, O. J. (2004). Development of a questionnaire to assess quality of life in patients with hepatocellular carcinoma, the EORTC QLQ-HCC18. European Journal of Cancer, 40(16), 2439–2444.

    Article  PubMed  Google Scholar 

  14. Chie, W. C., Blazeby, J. M., Hsiao, C. F., Chiu, H. C., Poon, R. T., Mikoshiba, N., et al. (2012). International cross-cultural field validation of an European Organization for Research and Treatment of Cancer questionnaire module for patients with primary liver cancer, the European Organization for Research and Treatment of Cancer quality-of-life questionnaire HCC18. Hepatology, 55(4), 1122–1129.

    Article  PubMed  Google Scholar 

  15. Mikoshiba, N., Tateishi, R., Tanaka, M., Sakai, T., Blazeby, J. M., Kokudo, N., et al. (2012). Validation of the Japanese version of the EORTC hepatocellular carcinoma-specific quality of life questionnaire module. Health and Quality of Life Outcomes, 10(1), 58.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Mickey, R. M., & Greenland, S. (1989). The impact of confounder selection criteria on effect estimation. American Journal of Epidemiology, 129(1), 125–137.

    CAS  PubMed  Google Scholar 

  17. Spreeuwenberg, M. D., Bartak, A., Croon, M. A., Hagenaars, J. A., Busschbach, J. J., Andrea, H., et al. (2010). The multiple propensity score as control for bias in the comparison of more than two treatment arms: An introduction from a case study in mental health. Medical Care, 48(2), 166–174.

    Article  PubMed  Google Scholar 

  18. Firth, D. (1993). Bias reduction of maximum likelihood estimates. Biometrika, 80, 27–38.

    Article  Google Scholar 

  19. Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.

    PubMed  Google Scholar 

  20. Yang, H. J., Lee, J. H., Lee, D. H., Yu, S. J., Kim, Y. J., Yoon, J. H., et al. (2014). Small single-nodule hepatocellular carcinoma: Comparison of transarterial chemoembolization, radiofrequency ablation, and hepatic resection by using inverse probability weighting. Radiology. doi:10.1148/radiol.13131760.

    Google Scholar 

Download references

Acknowledgments

This study was funded in part by the EORTC Quality of Life Group. JMB is funded in part by the MRC ConDuCT Hub. WCC is funded by the National Science Council, Taiwan, No. NSC97-2314-B002-020-MY3. HCC is funded by the National Science Council, Taiwan, NSC 95-2314-B-037-079-MY3.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standard

The original study was approved by institutional review boards at each center. All participants signed an informed consent form. The secondary analysis was conducted on de-identified data.

Author information

Authors and Affiliations

  1. Graduate Institute of Epidemiology and Preventive Medicine, Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan

    Wei-Chu Chie

  2. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Fang Yu & Mengqian Li

  3. Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Lorena Baccaglini

  4. School of Social & Community Medicine, University of Bristol, Bristol, UK

    Jane M. Blazeby

  5. Division of Clinical Trial Statistics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan

    Chin-Fu Hsiao & Chieh Chiang

  6. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan

    Herng-Chia Chiu

  7. Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong

    Ronnie T. Poon

  8. Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Naoko Mikoshiba

  9. Institute of Liver Studies, King’s College Hospital, London, UK

    Gillian Al-Kadhimi, Nigel Heaton & Jozer Calara

  10. Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    Peter Collins & Katharine Caddick

  11. Psychooncology Unit, Sant’Andrea Hospital-Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy

    Anna Costantini

  12. Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, France

    Valerie Vilgrain

  13. Université Paris Diderot, Sorbonne Paris Cité, INSERM Centre de recherche Biomédicale Bichat Beaujon, CRB3 U773 75018, Paris, France

    Valerie Vilgrain

Authors
  1. Wei-Chu Chie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fang Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mengqian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lorena Baccaglini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jane M. Blazeby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chin-Fu Hsiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Herng-Chia Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ronnie T. Poon
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Naoko Mikoshiba
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gillian Al-Kadhimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nigel Heaton
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jozer Calara
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Peter Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Katharine Caddick
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Anna Costantini
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Valerie Vilgrain
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Chieh Chiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fang Yu.

Additional information

On behalf of the EORTC Quality of Life Group.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chie, WC., Yu, F., Li, M. et al. Quality of life changes in patients undergoing treatment for hepatocellular carcinoma. Qual Life Res 24, 2499–2506 (2015). https://doi.org/10.1007/s11136-015-0985-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-015-0985-8

Keywords

Search

Navigation