Quality of life analysis after stereotactic radiofrequency ablation of liver tumors

Abstract

The purpose of this study was to evaluate the health-related quality of life (HRQoL) after stereotactic radiofrequency ablation (SRFA) of liver tumors and identify variables associated with decreased HRQoL and to compare it to other treatments in case of concurrency. From 2011 to 2017 577 patients underwent SRFA for liver tumors in 892 ablation sessions. 303 (52.5%) patients completed a HRQoL questionnaire once after the ablation. HRQoL was assessed by the Short Form (SF)-12 health survey with mental and physical component scales and by a general questionnaire to assess disease and treatment-specific items as well as to compare tolerability of SRFA to transarterial chemoembolization (TACE), hepatic resection (HR) and chemotherapy (CTX). The median SF-12 PCS was 46.6 and MCS was 53.2. Patients experiencing pain or complications and patients refusing repeat SRFA showed significantly lower PCS (43.2 vs 48.6, p = 0.0003; 32.8 vs 46.9, p = 0.005 and 40.6 vs 46.9, p = 0.009). 355 (97.8%) patients indicated willingness to undergo repeat SRFA with little to no fear in 292 (80.7%) patients. Among patients with multiple therapies, SRFA was rated by 40 (90.9%) as preferred re-treatment, HR by 1 (2.3%) and CTX by 3 (6.8%). In conclusion, we have shown that SRFA has good HRQoL-outcomes and reported low morbidity rates. Consequently the vast majority of study patients would accept a repeated SRFA if necessary (97.8%), without fear (80.7%). SRFA was preferred among patients who experienced concurrent treatments, such as HR or CTX.

Stereotactic Thermal Ablation of Liver Tumors: 3D Planning, Multiple Needle Approach, and Intraprocedural Image Fusion Are the Key to Success—A Narrative Review

“…One study [53] evaluated the health-related quality of life (HRQoL) after SRFA of liver tumors. Of 577 patients who underwent SRFA for liver tumors in 892 ablation sessions from 2011 to 2017, 303 patients (52.5%) returned 363 completed HRQoL questionnaires once after the ablation (50 patients with multiple questionnaires, due to multiple ablation sessions).…”

Stereotactic ablation: A game changer?

“…In conclusion, SRFA is a powerful and adaptable method for treating tumours of any size and shape. With its demonstrated effectiveness, reproducibility and teachability, this technique offers a promising treatment option for patients suffering from cancer, potentially improving survival rates and quality of life 53 …”

Editorial: is microwave ablation an alternative to liver resection for hepatocellular carcinoma? Authorsʼ reply

“…However, there are numerous studies that show MWA's advantages in terms of quality of life and post-operative morbidity compared to resection. 9,10 Minimally invasive small lesion ablation is now safely performed in many centres within a few minutes of analgosedation. 11 Ultimately, with comparable overall survival of MWA compared to resection, patient preference must also play an increasingly important role concerning allocation to the appropriate therapy after obtaining detailed informed consent about the procedures' advantages and disadvantages.…”

“…Third, the authors listed the physical and psychological burdens of patients as a consequence of the increased recurrence rate as a drawback of MWA. However, there are numerous studies that show MWA's advantages in terms of quality of life and post‐operative morbidity compared to resection 9,10 . Minimally invasive small lesion ablation is now safely performed in many centres within a few minutes of analgosedation 11 …”