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.
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Harrison TJ (1998) Viral hepatitis and primary liver cancer. In: Arrand JR, Harper DR (eds) Viruses and Human Cancer BIOS Scientific Publishers Limited, Oxford
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–333
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
Zabora J., Brintzenhofeszoc K., Curbow B., Hooker C., Piantadosi S. (2001) The prevalence of psychological distress by cancer site. Psycho-Oncol 20:19–28
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
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
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We would like to thank the American Cancer Society for their support of this research
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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
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DOI: https://doi.org/10.1007/s11136-006-9111-2