Skip to main content

Advertisement

SpringerLink
Log in

Health-related quality of life: Hepatocellular carcinoma, chronic liver disease, and the general population

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

Abstract

Health related quality of life (HRQL) has become an important endpoint in testing the efficacy of treatments for chronic liver disease (CLD) and the consequences of CLD which include hepatocellular carcinoma (HCC) and liver failure. However, a paucity of research on HRQL has been conducted with these patient populations. The aims of the present study were to compare persons diagnosed with HCC to persons diagnosed with CLD as well as with the general population (GP) on a disease-specific instrument measuring HRQL. If significant and clinically meaningful differences in HRQL exist, HRQL may be used as a corroborative indicator of disease progression in patients with CLD. Two hundred and seventy-two people participated in the present study. Of these participants, 83 were diagnosed with HCC, 51 with CLD, and 138 were from the GP. None of the patients in the HCC or CLD samples were actively receiving chemotherapeutic treatments for the CLD or HCC. A sociodemographic questionnaire and the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) was administered to participants. The results of the study suggested that people diagnosed with HCC, prior to treatment, had a poorer overall HRQL when compared to those persons with CLD and the general population, as expected. The differences in HRQL were statistically significant as well as clinically meaningful. People diagnosed with CLD and HCC respectively, reported better social and family well-being than the general population. Furthermore, people with CLD reported equivalent emotional well-being as the general population sample. HRQL subscale scores, with the exception of social and family well-being, discriminated group membership.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harrison TJ (1998) Viral hepatitis and primary liver cancer. In: Arrand JR, Harper DR (eds) Viruses and Human Cancer BIOS Scientific Publishers Limited, Oxford

    Google Scholar 

  2. Bonkovsky HL, Woolley JM, and the Concsensus Interferon Study Group (1999) Reduction of health related quality of life in chronic hepatitis C and improvement with interferon therapy. Hepatology 29(1):264–270

    Google Scholar 

  3. Martin LM, Sheriddan MJ, Younossi ZM (2002) The impact of liver disease on health related quality of life:A review of the literature. Current Gasteroenterol Rep 4(1):79–83

    Article  Google Scholar 

  4. Earlam S, Glover C, Fordy C, Burke D, Allen-Mersh TG (1996) Relation between tumor size, quality of life, and survival in patient with colorectal liver metastases. J Clin Oncol 14(1):171–175

    PubMed  CAS  Google Scholar 

  5. Pistevou-Gombaki K, Eleftheriadis N, Plataniotic GA, Sofroniadid I, Kouloulias VE (2003) Octreotide for palliative treatment of hepatic metastases from non-neuroendrocine primary tumours:Evaluation of quality of life using the EORTC QLQ-30 questionnaire. Palliat Med 17(3):257–262

    Article  PubMed  Google Scholar 

  6. Poon RTP, Fan ST, Yu WC, Lam BKY, Wong J (2001) A prospective longitudinal study of quality of life after resection of hepatocellular carcinoma. Arch Surg 136(6):693–699

    Article  PubMed  CAS  Google Scholar 

  7. Ueno S, Tanabe G, Nuruki K, Yoshidome S, Kubo F, Kihara K, Aoki D, Aikou T. Quality of life after hepatectomy in patients with hepatocellular carcinoma:Implications of change in hepatic protein synthesis. Hepato-Gastroenterology 2002; 49(44): 492–496

    Google Scholar 

  8. Steel J.L., Geller D.A., Carr B.I. (2005) Proxy Ratings of Health Related Quality of Life in Patients with Hepatocellular Carcinoma. Qual Life Res 14:1025–1033

    Article  PubMed  Google Scholar 

  9. Steel J.L., Carr B.I., Baum A. (2004) Quality of life in patients diagnosed with primary hepatocellular carcinoma:Hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere®). Psycho-Oncol 13(2):73–79

    Article  Google Scholar 

  10. Steel JL, Eton DT, Cella D, Olek MC, Carr BI. Clinically meaningful changes in health related quality of life in patients diagnosed with hepatobiliary carcinoma. Ann Oncol, in press

  11. Hefferman S, Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The Functional Assessment of Cancer Therapy scale:Development and validation of the general measure. J Clin Oncol 11(3):570–579

    Google Scholar 

  12. Blazeby JM, Currie E, Zee BCY, Chie W-C, Poon RT, Garen OJ, on behalf of the EORTC Quality of Life Group. Development of a questionnaire module to supplement the EORTC QLQ-C30 to assess quality of life in patients with hepatocellular carcinoma, the EORTC QLQ-HCC18. Eur J Cancer 2004; 40(16): 2439–2444

    Google Scholar 

  13. Pokros PJ, Shiffman ML, Schoff ER, Sulkowski MS, Younossi Z, Dieterich DT, Wright TL, Mody SH,, Tang KL, Goon BL, Bowers PJ, Leitz G, Afdhal NH (2004) Epoetin alfa improves quality of life in anemic HCV-infected patients receiving combination therapy. Hepatogology 40(6):1450–1458

    Article  CAS  Google Scholar 

  14. Casanovas T, Vallejo G, Herdman M, Casado A, Ribas S, Rodriquez FE, Tremosa G, Menchon JM, Figueras J, Casais LA (2003) Validation of the Spanish version of the Liver Disease Quality of Life questionnaire in transplant patients. Transplant Proc 35(5):1803–1805

    Article  PubMed  CAS  Google Scholar 

  15. van der Plas SM, Hansen BE, deBoer JB, Stijnen T, Passchier J, de Man RA, Schalm SW (2004) The Liver Disease Symptom Index 2.0:Validation of a disease specific questionnaire. Qual Life Res 13(8):1469–1481

    Article  PubMed  Google Scholar 

  16. Hauser W, Schnur M, Steder-Neukamm U, Muthny FA, Grandt D (2004) Validation of the German version of the Chronic Liver Disease Questionnaire. Eur J Gastroenterol Hepatol 16(6):599–606

    Article  PubMed  Google Scholar 

  17. Gralnek IM, Hays RD, Kilbourne A, Rosen HR, Artinian L, Kim S, Lazarovici D, Jensen DM, Busuttil RW, Martin P (2000) Development and evaluation of the liver disease quality of life instrument in persons with advanced, chronic liver disease-the LDQOL 1.0. Am J Gasteroenterol 95(12):3552–3365

    CAS  Google Scholar 

  18. Chow PK, Tai BC, Tan CK, Machin D, Win KM, Johnson PJ, Soo KC, and the Asian-Pacific Hepatocellular Carcinoma Trials Group. High dose tamoxifen in the treatment of inoperable hepatocellular carcinoma:A multicenter randomized controlled trial. Hepatology 2002; 36(5): 122–1226

    Google Scholar 

  19. Brans B, Lambert B, DeNeule E, De Winter F, Van Belle S, Van Vlierberghe H, de Hemptinne B, Dierckz RA (2002) Quality of life assessment in radionuclide therapy:A feasibility study of the EORTC QLQ-C30 questionnaire in palliative (131) I-lipiodol therapy. Eur J Nucl Med Mol Imaging 29(1):1374–1379

    Article  PubMed  CAS  Google Scholar 

  20. Hauser W, Holtmann G, Grandt D (2004) Determinants of health-related quality of life in patients with chronic liver disease. Clin Gasteroenterol Hepatol 2(2):157–163

    Article  Google Scholar 

  21. Younossi ZM, Guyatt G, Kiwi M, Boparai N, King D (1999) Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease. Gut 45(2):295–300

    Article  PubMed  CAS  Google Scholar 

  22. Younossi ZM, Boparai N, Price LL, Kiwi ML, McComrmick M, Guyatt G (2001) Health related quality life in chronic liver disease:the impact of the type and severity of disease. Am J Gastroenteronol 96(7):199–205

    Google Scholar 

  23. Bianchi G, Loguercio C, Sgarbi D, Abbiati R, Brunetti N, DeSimone T, Zoli, M, Marchesini G (2003) Reduced quality of life of patients with hepatocellular carcinoma. Dig Liver Dis 35(1):46–54

    Article  PubMed  CAS  Google Scholar 

  24. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. J Clin Oncol 11(3):570–579

    CAS  Google Scholar 

  25. Webster K, Cella D, Yost, K (2003) The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System:properties, applications, and interpretation. Health Qual Life Outcomes 1:11–18

    Article  Google Scholar 

  26. Brucker PS, Yost K, Cashy J, Webster K, Cella D (2005) General population and cancer patient norms for the Functional Assessment of Cancer Therapy-General (FACT-G). Eval Health Prof 28(2):192–211

    Article  PubMed  Google Scholar 

  27. Steel JL, Eton D, Cella D, Olek M, Carr BI. Measuring health related quality of life in patients with hepatobiliary carcinoma. Annals of Oncology 2005, in press

  28. Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–333

    Article  Google Scholar 

  29. Arguedas MR, DeLawrence TG, Mc Guire BM (2003) Influence of hepatic encephalopathy on health related quality of life in patients with cirrhosis. Dig Dis Sci 48(8):1622–1626

    Article  PubMed  Google Scholar 

  30. Zabora J., Brintzenhofeszoc K., Curbow B., Hooker C., Piantadosi S. (2001) The prevalence of psychological distress by cancer site. Psycho-Oncol 20:19–28

    Article  Google Scholar 

  31. Scalori A, Pozzi M, Bellia V, Apale P, Santamaria G, Bordoni T, Redaelli A, Avolio A, Parravicini P, Pioltelli P, Roffi L (2005) Interferon-induced depression:prevalence and management. Dig Liver Dis 37(2):102–107

    Article  PubMed  CAS  Google Scholar 

  32. Park CK, Park SY, Kim ES, Park JH, Hyun DW, Yun YM, Jo CM, Tak WY, Kweon YO, Kim SK, CHoi YH, Park SG (2003) Assessment of quality of life and associated factors in patients with chronic viral liver disease. Korean J Hepatol 9(3):212–221

    Google Scholar 

Download references

Acknowledgement

We would like to thank the American Cancer Society for their support of this research

Author information

Authors and Affiliations

  1. University of Pittsburgh School of Medicine; Starlz Transplantation Institute, Liver Cancer Center, 3459 Fifth Avenue; Montefiore 7 S, Pittsburgh, PA, 15213, USA

    Jennifer L. Steel & Brian I. Carr

  2. University of Pittsburgh, Center for Liver Disease, Pittsburgh, PA, USA

    Kapil Chopra

  3. University of Pittsburgh, Liver Cancer Center, Pittsburgh, PA, USA

    Marion C. Olek

Authors
  1. Jennifer L. Steel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kapil Chopra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marion C. Olek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian I. Carr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer L. Steel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steel, J.L., Chopra, K., Olek, M.C. et al. Health-related quality of life: Hepatocellular carcinoma, chronic liver disease, and the general population. Qual Life Res 16, 203–215 (2007). https://doi.org/10.1007/s11136-006-9111-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-006-9111-2

Keywords

Search

Navigation