Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90

Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Due to the advanced stage in which HCC presents, most patients are only eligible for transarterial chemoembolization (TACE) or radioembolization (Y90). The purpose of this study is to examine the difference...

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Main Authors: Kathryn Bress, Patrick Bou-Samra, Cramer J. Kallem, Allan Tsung, Ellie Gammer, David A. Geller, James W. Marsh, Jennifer L. Steel
Format: Article
Language:English
Published: SpringerOpen 2025-04-01
Series:Journal of the Egyptian National Cancer Institute
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Online Access:https://doi.org/10.1186/s43046-025-00267-1
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author Kathryn Bress
Patrick Bou-Samra
Cramer J. Kallem
Allan Tsung
Ellie Gammer
David A. Geller
James W. Marsh
Jennifer L. Steel
author_facet Kathryn Bress
Patrick Bou-Samra
Cramer J. Kallem
Allan Tsung
Ellie Gammer
David A. Geller
James W. Marsh
Jennifer L. Steel
author_sort Kathryn Bress
collection DOAJ
description Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Due to the advanced stage in which HCC presents, most patients are only eligible for transarterial chemoembolization (TACE) or radioembolization (Y90). The purpose of this study is to examine the differences in survival and health-related quality of life (HRQOL) in patients diagnosed with HCC and treated with TACE or Y90. Methods Two hundred thirty-four patients with HCC were enrolled in studies examining HRQOL between 2003–2009. HRQOL was evaluated using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). Between-group differences were examined using chi-square and ANOVA. Survival was assessed using Kaplan–Meier and Cox regression analyses. Results Significant baseline differences between patients treated with TACE versus Y90 were found. Patients who received Y90 tended to be older (p < 0.001), female (p < 0.001), had fewer lesions (p = 0.03), had smaller tumors (p = 0.03), and were less likely to have vascular invasion (p = 0.04). After adjusting for demographic and disease-specific factors, no significant differences in HRQOL were observed at 3 months (p = 0.79) or 6 months (p = 0.75). Clinically meaningful differences were found, with the TACE group reporting greater physical, social, and emotional well-being at 3 and 6 months and greater overall HRQOL at 6 months. No significant differences in survival were found. Conclusions Treatment with TACE and Y90 was similar with regard to survival. However, TACE showed statistically and clinically meaningful benefits in physical, social/family, and emotional well-being. Further research is warranted to identify profiles of patients who may demonstrate a preferential response to either TACE or Y90.
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spelling doaj-art-0111151c4d404fc49b26f3c42f50cc882025-08-20T02:17:56ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092025-04-013711810.1186/s43046-025-00267-1Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90Kathryn Bress0Patrick Bou-Samra1Cramer J. Kallem2Allan Tsung3Ellie Gammer4David A. Geller5James W. Marsh6Jennifer L. Steel7Department of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterDepartment of Surgery, University of Pittsburgh Medical CenterAbstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Due to the advanced stage in which HCC presents, most patients are only eligible for transarterial chemoembolization (TACE) or radioembolization (Y90). The purpose of this study is to examine the differences in survival and health-related quality of life (HRQOL) in patients diagnosed with HCC and treated with TACE or Y90. Methods Two hundred thirty-four patients with HCC were enrolled in studies examining HRQOL between 2003–2009. HRQOL was evaluated using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). Between-group differences were examined using chi-square and ANOVA. Survival was assessed using Kaplan–Meier and Cox regression analyses. Results Significant baseline differences between patients treated with TACE versus Y90 were found. Patients who received Y90 tended to be older (p < 0.001), female (p < 0.001), had fewer lesions (p = 0.03), had smaller tumors (p = 0.03), and were less likely to have vascular invasion (p = 0.04). After adjusting for demographic and disease-specific factors, no significant differences in HRQOL were observed at 3 months (p = 0.79) or 6 months (p = 0.75). Clinically meaningful differences were found, with the TACE group reporting greater physical, social, and emotional well-being at 3 and 6 months and greater overall HRQOL at 6 months. No significant differences in survival were found. Conclusions Treatment with TACE and Y90 was similar with regard to survival. However, TACE showed statistically and clinically meaningful benefits in physical, social/family, and emotional well-being. Further research is warranted to identify profiles of patients who may demonstrate a preferential response to either TACE or Y90.https://doi.org/10.1186/s43046-025-00267-1Health-related quality of lifeSurvival analysisHepatocellular carcinomaTransarterial chemoembolizationRadioembolization
spellingShingle Kathryn Bress
Patrick Bou-Samra
Cramer J. Kallem
Allan Tsung
Ellie Gammer
David A. Geller
James W. Marsh
Jennifer L. Steel
Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
Journal of the Egyptian National Cancer Institute
Health-related quality of life
Survival analysis
Hepatocellular carcinoma
Transarterial chemoembolization
Radioembolization
title Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
title_full Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
title_fullStr Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
title_full_unstemmed Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
title_short Health-related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and Yttrium-90
title_sort health related quality of life and survival of patients with hepatocellular carcinoma treated with transarterial chemoembolization and yttrium 90
topic Health-related quality of life
Survival analysis
Hepatocellular carcinoma
Transarterial chemoembolization
Radioembolization
url https://doi.org/10.1186/s43046-025-00267-1
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