Elsevier

Transplantation Proceedings

Volume 48, Issue 6, July–August 2016, Pages 2107-2111
Transplantation Proceedings

Horizons in Transplantation
Liver transplantation
Health-Related Quality of Life and Psychological Distress in Patients With Early-Stage Hepatocellular Carcinoma After Hepatic Resection or Transplantation

https://doi.org/10.1016/j.transproceed.2016.04.012Get rights and content

Highlights

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    The demographics of the patients in the 2 groups were similar, and there were no significant differences, except for higher family income in the transplantation group (P = .002).

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    With long-term follow-up, there were no significant differences in the 8 domains of the HRQOL and the 9 domains of the psychological outcome measure between the 2 groups.

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    Both the transplantation and resection groups exhibited good outcomes in both HRQOL and psychological outcome measures.

Abstract

Background

The aim of our study was to compare the post-operative health-related quality of life in patients with small hepatocellular carcinoma (HCC; within the Milan criteria) after liver resection or liver transplantation.

Methods

From August 2000 to December 2010, 207 patients were diagnosed with early HCC within the Milan criteria. We divided these patients into 2 groups according to their curative schedule: the liver transplantation group (n = 95) and the liver resection group (n = 110). We compared the baseline characteristics of these 2 groups of patients, after which we focused on comparing the post-operative health-related quality of life (HRQOL) and psychological outcome in these 2 groups.

Results

The demographics of the patients in the 2 groups were similar, and there were no significant differences except for higher family income in the transplantation group (P = .002).With long-term follow-up, there were no significant differences in the 8 domains of the HRQOL and the 9 domains of the psychological outcome measure between the 2 groups. Both the transplantation and resection groups exhibited good outcomes in both HRQOL and psychological outcome measures.

Conclusions

Several years after operation, early-stage HCC patients who underwent liver transplantation or resection had similar long-term HRQOL and psychological outcomes.

Section snippets

Patients and Study Design

Between August 2000 and July 2010, 269 patients were diagnosed with early HCC within the Milan criteria at the West China Hospital of Sichuan University. They underwent liver resection or transplantation and were observed until October 2013. The inclusion criteria were as follows: age ≥18 years, diagnosis of early HCC, underwent resection or transplantation at least 3 years prior, ability to understand Chinese, had at least 6 months of follow-up, and did not have suicidal indications or a

Baseline Characteristics

All of the patients signed informed consent for participation, and they all completed the validated questionnaires by interview or mail. The results of the questionnaires from interviews or mail were not significantly different. Table 1 shows the demographics of these patients and their tumor characteristics. The mean age of the patients in the transplantation group was older (48.1 vs 45.4 years) than that in the resection group, but this difference did not reach statistical significance (P =

Discussion

Liver transplantation, including living-donor LT and deceased LT, is the first choice for treating early HCC with hepatitis B virus or hepatitis C virus because of its theoretical advantage of removing the tumor and the organ at risk of developing future malignancy [15]. However, during recent years, especially in China, the persistent imbalance between the increasing numbers of candidates for LT and the limited organ supply has made it necessary to reduce the use of LT [15]. Although LT has

Conclusions

HRQOL and psychological outcome must be considered as important as survival when assessing treatments for patients with HCC. Patients who accepted transplantation and resection for early HCC exhibited similar long-term HRQOL levels and psychological outcomes. Patients who underwent transplantation or resection also exhibited an acceptable HRQOL and psychological outcomes.

Acknowledgments

The authors thank the China Liver Transplant Registry System for providing part of the data.

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