Surgical treatment for non-parasitic liver cysts improves quality of life |
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| Affiliation: | 1. University of Groningen, University Medical Center Groningen, Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands;2. Leiden University Medical Center, Department of Surgery, Leiden, the Netherlands;3. Department of Surgery, Isala Clinics Zwolle, Zwolle, the Netherlands;4. University of Groningen, University Medical Center Groningen, Department of Surgical Oncology, Groningen, the Netherlands;1. S. Orsola University Hospital, Emergency Surgery Unit, University of Bologna, Italy;2. DIMES University of Bologna, Italy;3. Addenbrookes Hospital – University of Cambridge, UK;1. Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle University NHS Foundation Trust Hospitals, Newcastle Upon Tyne, UK;2. Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK;1. University of Aberdeen, Aberdeen, UK;2. Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK;1. Department of Surgery, Lambe Institute, National University of Ireland, Galway, Ireland;2. Department of Colorectal Surgery, Beaumont University Hospital, Dublin, Ireland |
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| Abstract: | Background&purposeLiver cysts occur frequently. Most are harmless, however some carry a significant patient burden. Optimizing treatment strategy is complicated as needs differ between patients. The current study assesses the effect of surgery on quality of life (QoL) of patients with non-parasitic liver cysts.MethodsA retrospective cohort study of all patients who underwent surgery for non-parasitic liver cysts in three major Dutch medical centers from 1993 to 2017. Patient characteristics and surgery related variables were collected from the electronic patient file. QoL was measured before and after surgery using the EORTC QLQ-C30. Summary scores (SumSc) were calculated and compared to reference values of the general population. Multivariate analysis using logistic regression was performed for identifying outcome related factors. Increase of ≥ 10% in SumSc was defined as clinically relevant.Main findingsEighty-eight of 132 eligible patients (67%) completed two QoL assessments. Respondents demonstrated significant improvement in the global health status, on all 5 functional scales (all p ≤ 0.005), on all 9 symptom scales after surgery (all p < 0.05), and on SumSc (p < 0.001) to levels similar or better than the general population. Patients with complications demonstrated a significant QoL gain (p < 0.05), and reported a similar postoperative status compared to patients without complications (p = 0.74). QoL gain for patients who underwent open and laparoscopic cyst fenestration were similar (p = 0.08). Multivariate analysis of SumSc found mechanical complaints as significant factor for ≥ 10% SumSc increase (OR 0.11, 95% CI (0.02–0.55).ConclusionsSurgery is a safe and effective strategy to significantly improve QoL in patients with symptomatic liver cysts. |
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| Keywords: | Liver cyst QoL Treatment strategy EORTC QLQ-C30 PCLD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" Polycystic Liver Disease QoL" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" Quality of Life EORTC QLQ-C30" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 SumSc" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" Summary Score CCI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" Comprehensive Complication Index IQR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0085" }," $$" :[{" #name" :" text" ," _" :" Interquartile Range |
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