Prognosis and Quality of Life after Hepatectomy in Patients with Hepatocellular Carcinoma

Shinichi Ueno, Gen Tanabe, Kensuke Nuruki, Shinrou Yoshidome, Kenji Kihara, Makoto Maemura and Takashi Aikuou

First Department of Surgery, Kagoshima University School of Medicine

This study was undertaken to investigate the correlation between the prognosis and the quality of life (QOL) after hepatectomy in 203 patients with primary hepatocellular carcinoma (HCC), who received curative resections between 1980 and 1997. One-hundred eleven patients who survived more than 1 year following the operation answered our original questionnaire.
The results obtained were as follows:
1)The QOL, especially physical condition, was relatively satisfactory 1 year after hepatectomy, however, informed consest at initial surgery or recurrence was important.
2)The QOL in the patients with recurrence deteriorated when the disease free period was less than 1 year, or when receiving therapy for recurrent HCC.
3)The prognosis and QOL was much better in patients with normal, that is chronic persistent hepatitis (CPH), however, in patients with chronic active hepatitis (CAH), the high incidence of early recurrence and the therapies for recurrence or for hepatitis impaired their social and/or psychological functions. Patients with liver cirrhosis (LC) also showed high recurrence rates and 50% had multi-centric occurrence. Patients with severe postoperative complications tended to develop long-term (2-7 year) impaired performances. Given these considerations, curative resection in patients with normal CPH liver was effective, however, strategies to prolong the disease free survival period in CAH patients and treatments for primary or recurrent HCC in LC patients should be selected with the most favorable prognosis and the best QOL for each patint as the goal.

Key words
hepatocellular carcinoma, quality of life after hepatectomy, multi-centric occurrence

Reprint requests
Shinichi Ueno First Department of Surgery, Kagoshima University School of Medicine 8-35-1 Sakuragaoka, Kagoshima, 890-0075 JAPAN

Accepted
January 27, 1999

To read the PDF file you will need Abobe Reader installed on your computer.