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J Clin Med. 2019 Apr 27;8(5). pii: E576. doi: 10.3390/jcm8050576.

Preoperative Health-Related Quality of Life Predicts Minimal Clinically Important Difference and Survival after Surgical Resection of Hepatocellular Carcinoma.

Chiu CC1,2,3, Lee KT4,5, Wang JJ6, Sun DP2, Lee HH7, Huang CC8,9, Shi HY10,11,12.

Author information

1
Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan. sdp0127@gmail.com.
2
Department of General Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan. sdp0127@gmail.com.
3
Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan. sdp0127@gmail.com.
4
Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan. ktlee@kmu.edu.tw.
5
Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan. ktlee@kmu.edu.tw.
6
Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan. 400002@mail.chimei.org.tw.
7
Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan. hao_hsien@hotmail.com.
8
Department of Emergency Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan. honyi6165@yahoo.com.
9
Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan. honyi6165@yahoo.com.
10
Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan. hshi@kmu.edu.tw.
11
Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan. hshi@kmu.edu.tw.
12
Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan. hshi@kmu.edu.tw.

Abstract

Despite the growing use of minimal clinically important difference (MCID) as a cancer outcome measure, no study has reported clinically significant outcomes in cancer patients. We defined MCID and evaluated the use of preoperative HRQoL for predicting MCID and survival after surgical resection of hepatocellular carcinoma (HCC). In total, 369 patients completed the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) and the SF-36 at baseline and at two years post-operative at three tertiary academic hospitals. The corresponding MCID values were 3.6 (SF-36 physical component summary), 4.2 (SF-36 mental component summary), 5.4 (FACT-General total score), and 6.7 (FACT-Hep total score). The predictors of achieving postoperative MCID were significantly higher in patients who had low preoperative HRQoL score, advanced age, high education level, and high BMI (p < 0.05). However, patients with a high preoperative HRQoL score, high education level, high BMI, and low Charlson comorbidity index score were significantly associated with survival (p < 0.05). Preoperative HRQoL scores were predictive of MCID and overall survival after surgical resection of HCC. The findings of this study may be useful for managing the preoperative expectations of candidates for HCC resection and for developing shared decision-making procedures for patients undergoing surgical resection of HCC.

KEYWORDS:

health-related quality of life; hepatocellular carcinoma; minimal clinically important difference; survival

PMID:
31035539
DOI:
10.3390/jcm8050576
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