title: Longitudinal quality of life assessment of patients with hepatocellular carcinoma after primary transarterial chemoembolization.
abstract: OBJECTIVE
  To determine the effects of primary chemoembolization on the health-related quality of life (HRQOL) of patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Single-center prospective data collection with longitudinal analysis of HRQOL scores obtained via the Short Form-36 (SF-36) assessment tool was performed before and during serial chemoembolization procedures in 73 patients with HCC. Baseline HRQOL scores were evaluated for significant (P < .05) change within the total patient population during 4, 8, and 12 months of treatment, and separately within a subset of 23 patients who underwent three or more chemoembolization procedures.
  
  
  RESULTS
  Patients had decreased pretreatment baseline scores within all eight scales of the SF-36 compared with healthy age-adjusted norms. Within the total population, mental health scores improved after 4 months of chemoembolization (rate of change, 5.6; P = .05; n = 48), but no significant change was present at 8 or 12 months. Subset patients experienced improvements of mental health scores after the first (score change, 13; P = .008; n = 21) and second procedures (score change, 12.2; P = .002; n = 23) and improvements of bodily pain scores (score change, 9.9; P = .047; n = 21) after the initial procedure. Vitality scores worsened (score change, -7.8; P = .044; n = 21) in the subset after the first chemoembolization.
  
  
  CONCLUSIONS
  Patients with HCC are likely to perceive improved mental health during the first 4 months of primary treatment with chemoembolization. In addition, if patients ultimately undergo more than two procedures, they are likely to perceive improved mental health during the first two sessions, with decreased bodily pain during the initial session. Patient-perceived vitality will likely worsen after the initial procedure.
authors.affiliation: Department of Radiology, University of Missouri Kansas City School of Medicine, Saint Luke's Hospital, 4401 Wornall Rd, Kansas City, MO 64111, USA. bwible@saint-lukes.org
authors.forename: Brandt C
authors.initials: BC
authors.lastname: Wible
authors.forename: William S
authors.initials: WS
authors.lastname: Rilling
authors.forename: Peter
authors.initials: P
authors.lastname: Drescher
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hieb
authors.forename: Kia
authors.initials: K
authors.lastname: Saeian
authors.forename: Constantine
authors.initials: C
authors.lastname: Frangakis
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
authors.forename: Daniel
authors.initials: D
authors.lastname: Eastwood
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D016896:Treatment Outcome