TY - JOUR
T1 - Improvements in quality of life after surgery for benign hepatic tumors
T2 - Results from a dual center analysis
AU - Kneuertz, Peter J.
AU - Marsh, J. Wallis
AU - De Jong, Mechteld C.
AU - Covert, Keaton
AU - Hyder, Omar
AU - Hirose, Kenzo
AU - Schulick, Richard D.
AU - Choti, Michael A.
AU - Geller, David A.
AU - Pawlik, Timothy M.
N1 - Funding Information:
Supported in part by the Jill Williams Memorial Research Fund .
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/8
Y1 - 2012/8
N2 - Background: Outcomes after operative management of benign hepatic lesions are ill-defined. We sought to define patient-reported quality of life (QOL) postoperatively for benign hepatic tumors. Methods: Patients who underwent surgery for benign liver lesions (n = 255) were invited to complete a QOL survey designed using validated assessment tools. Clinicopathologic data were collected from 2 participating hepatobiliary centers and correlated with QOL data. Results: The response rate was 70.2%. Most patients had a benign cystic (41.9%) or solid (47.5%) tumor; 19 (10.6%) patients had an indeterminate lesion. The lesion was most often solitary (71.5%) and median size was 7.5 cm. Most benign lesions were either a simple cyst (35.8%), hemangioma (19.6%), focal nodular dysplasia (19.6%), or hepatic adenoma (16.9%). Presenting symptoms included abdominal pain (70.9%), nausea/vomiting (5.0%), and early satiety (5.0%). Surgery involved less than hemihepatectomy (68.2%); a laparoscopic approach was utilized in 40.8% of patients. Perioperative morbidity was 16%. Postoperatively, the proportion of patients who reported moderate-to-extreme pain decreased from 46.9% to 15.6% and 6.8% at 6 months and 1-year, respectively (P <.001). Patient self-reported mean pain scores also decreased over time (preoperative, 1.65 vs 6 months, 0.63 vs 1 year, 0.28; P <.001). Patients with "moderate-to-extreme" pain preoperatively were more likely to report an improvement in pain scores (odds ratio, 1.96; 95% confidence interval, 1.05-3.66; P =.03). Many patients reported overall improvement in general health (40.5%) and physical health (39.3%; P <.001). Conclusion: Surgery for benign liver lesions is associated with high patient satisfaction and improved QOL. Patients with significant preoperative symptoms derive the most benefit from surgery.
AB - Background: Outcomes after operative management of benign hepatic lesions are ill-defined. We sought to define patient-reported quality of life (QOL) postoperatively for benign hepatic tumors. Methods: Patients who underwent surgery for benign liver lesions (n = 255) were invited to complete a QOL survey designed using validated assessment tools. Clinicopathologic data were collected from 2 participating hepatobiliary centers and correlated with QOL data. Results: The response rate was 70.2%. Most patients had a benign cystic (41.9%) or solid (47.5%) tumor; 19 (10.6%) patients had an indeterminate lesion. The lesion was most often solitary (71.5%) and median size was 7.5 cm. Most benign lesions were either a simple cyst (35.8%), hemangioma (19.6%), focal nodular dysplasia (19.6%), or hepatic adenoma (16.9%). Presenting symptoms included abdominal pain (70.9%), nausea/vomiting (5.0%), and early satiety (5.0%). Surgery involved less than hemihepatectomy (68.2%); a laparoscopic approach was utilized in 40.8% of patients. Perioperative morbidity was 16%. Postoperatively, the proportion of patients who reported moderate-to-extreme pain decreased from 46.9% to 15.6% and 6.8% at 6 months and 1-year, respectively (P <.001). Patient self-reported mean pain scores also decreased over time (preoperative, 1.65 vs 6 months, 0.63 vs 1 year, 0.28; P <.001). Patients with "moderate-to-extreme" pain preoperatively were more likely to report an improvement in pain scores (odds ratio, 1.96; 95% confidence interval, 1.05-3.66; P =.03). Many patients reported overall improvement in general health (40.5%) and physical health (39.3%; P <.001). Conclusion: Surgery for benign liver lesions is associated with high patient satisfaction and improved QOL. Patients with significant preoperative symptoms derive the most benefit from surgery.
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U2 - 10.1016/j.surg.2012.05.004
DO - 10.1016/j.surg.2012.05.004
M3 - Article
C2 - 22828140
AN - SCOPUS:84864199603
SN - 0039-6060
VL - 152
SP - 193
EP - 201
JO - Surgery (United States)
JF - Surgery (United States)
IS - 2
ER -