Improvements in quality of life after surgery for benign hepatic tumors: Results from a dual center analysis

Peter J. Kneuertz, J. Wallis Marsh, Mechteld C. De Jong, Keaton Covert, Omar Hyder, Kenzo Hirose, Richard D. Schulick, Michael A. Choti, David A. Geller, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)193-201
Number of pages9
JournalSurgery (United States)
Volume152
Issue number2
DOIs
StatePublished - Aug 2012

ASJC Scopus subject areas

  • Surgery

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