Background
Assessment of quality of life (QOL) after a major operation has become increasingly
pertinent to patient care and may be as important as long-term survival in cancer
patients. No current study has evaluated the long-term quality-of-life effects or
the time to return to baseline quality of life in oncology patients undergoing hepatic
resection for cancer. Thus, the aim of our study was to evaluate that the time to
return to baseline QOL after major and minor hepatectomy is similar to other major
abdominal operations.
Methods
A prospective study of 32 patients with malignant liver tumors completed the FACT-Hep,
FACT-FHSI-8, EORTC QLQ-C30, Profile of Mood States, EORTC QLQ-Pan26, and Global Rating
Scale at the time of consent, discharge, first postoperative visit, 6 weeks, 3 months,
6 months, and 12 months.
Results
Twenty-four patients underwent major (>2 segments) and 8 minor hepatectomy. Patients
who underwent major hepatectomy demonstrated a significant loss in FACT-physical and
functional scores at first postoperative visit and 6 weeks (P = .04) with return to baseline at 3 months. Similar nadir in all quality-of-life
assessment scores were observed for POMS, EORTC QLQ-C30, FHSI-8, and certain global
rating scales at 6 weeks, with a return to baseline at 3 months. For minor hepatectomy,
the nadir for most quality-of-life scores occurred at the first postoperative visit
with a return to baseline at 6 weeks.
Conclusion
Patients undergoing major hepatectomy return to their baseline quality of life at
3 months with a progressive and sustained increase in physical, emotional, and global
rating scale at 6 months. This study is the first one to demonstrate that major hepatectomy
can be performed with short-term adverse QOL effects and long-term improvements in
overall QOL.
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References
- Quality of life: philosophical question or clinical reality?.BMJ. 1992; 305: 466-469
- Summary of the second international conference on biology, prevention and treatment of gastrointestinal malignancies.Ann Oncol. 1995; 6: 645-649
- Quality-of-life measurement in surgical practice.Br J Surg. 1993; 80: 163-169
- Quality of life in patients with cancer of the esophagus and gastric cardia: a case for palliative resection.Arch Surg. 1998; 133: 316-322
- Quality of life following radical surgical treatment of gastric carcinoma.World J Surg. 1999; 23: 503-508
- Quality of life after treatment for rectal cancer.Br J Surg. 1998; 85: 1036-1043
- Quality of life, nutritional status and gastrointestinal hormone profile following the Whipple procedure.Ann Oncol. 1999; 10: 281-284
- A prospective longitudinal study of quality of life after resection of hepatocellular carcinoma.Arch Surg. 2001; 136: 693-699
- Assessment of symptom experience in patients undergoing hepatic resection or ablation.Cancer. 2006; 107: 2715-2722
- Le foie: Etudes anatomiques et Chirurgicales.Masson & Cie, Paris1957
- Perioperative outcomes of major hepatic resections under low central venous pressure anesthesia: blood loss, blood transfusion, and the risk of postoperative renal dysfunction.J Am Coll Surg. 1998; 187: 620-625
- Notes on the arrest of hepatic hemorrhage due to trauma.Ann Surg. 1908; 48: 541
- The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion?.J Am Coll Surg. 2003; 196: 402-409
- Morbidity of adjuvant hepatic arterial infusion pump chemotherapy in the management of colorectal cancer metastatic to the liver.Am J Surg. 2004; 188: 714-721
- Measuring health-related quality of life in patients with hepatobiliary cancers: the functional assessment of cancer therapy-hepatobiliary questionnaire.J Clin Oncol. 2002; 20: 2229-2239
- Assessment of patient-reported clinical outcome in pancreatic and other hepatobiliary cancers: the FACT Hepatobiliary Symptom Index.J Pain Symptom Manage. 2002; 24: 32
- The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.J Natl Cancer Inst. 1993; 85: 365-376
- [Quality of life assessment in pancreatic carcinoma: results of an European multicentric study].Chir Ital. 1999; 51: 359-366
- A brief POMS measure of distress for cancer patients.J Chronic Dis. 1987; 40: 939-942
- Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma.J Clin Oncol. 2005; 23: 2038-2048
- Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates.Ann Oncol. 2005; 16: 1311-1319
- Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival.Ann Surg. 2004; 240: 644-657
- CASH (Chemotherapy-Associated Steatohepatitis) costs.Ann Surg. 2006; 243: 8-9
- Surgical resection after downsizing of colorectal liver metastasis in the era of bevacizumab.J Clin Oncol. 2005; 23: 4853-4855
- Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases.Ann Surg. 2006; 243: 1-7
- Living donor adult liver transplantation: a longitudinal study of the donor’s quality of life.Am J Transplant. 2005; 5: 2770-2777
- Donor quality of life after living donor liver transplantation.Transplant Proc. 2004; 36: 912-913
- Quality of life of living donors before and after living donor liver transplantation.Transplant Proc. 2003; 35: 2961-2963
- Donor safety and quality of life after left hepatic lobe donation in living-donor liver transplantation.Transplant Proc. 2003; 35: 2768-2769
- Quality of life after lobectomy for adult liver transplantation.Transplantation. 2002; 73: 1593-1597
- Donor evaluation, donor risks, donor outcome, and donor quality of life in adult-to-adult living donor liver transplantation.Liver Transpl. 2002; 8: 829-837
Article info
Publication history
Accepted:
April 24,
2007
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
