A Prospective Longitudinal Study of Quality of Life After Resection of Hepatocellular Carcinoma

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Abstract
HEPATIC RESECTION is the mainstay of curative treatment of patients with hepatocellular carcinoma (HCC). Hepatectomy has become a safe operation with a low operative mortality rate as a result of recent advances in surgical technology and perioperative care.1,2 However, the long-term results after hepatic resection remain unsatisfactory. A cumulative 5-year recurrence rate in the range of 75% to 100% has been reported from most centers.3 In a strict sense, hepatic resection for HCC cannot be considered curative with such a high recurrence rate.4 Hence, it is important to consider the quality of life (QOL) as a treatment outcome in addition to the operative mortality and long-term survival rates. As most HCCs occur in patients with chronic liver diseases, hepatic resection could theoretically result in reduced QOL in these patients owing to a further compromise in liver function. Furthermore, early postoperative recurrence is a common event after resection of HCC and requires aggressive treatment with therapies such as transarterial chemoembolization (TACE) to prolong survival,5 which could potentially lead to impairment in QOL.