A Cross-Sectional Evaluation of Quality of Life Among Patients with Hepatic Adenomas
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RESEARCH COMMUNICATION
A Cross-Sectional Evaluation of Quality of Life Among Patients with Hepatic Adenomas Emily A. Armstrong 1 & Aslam Ejaz 1 & Angela Sarna 1 & Lanla Conteh 1 & Allan Tsung 1 & Timothy M. Pawlik 1 & Jordan M. Cloyd 1
# 2020 The Society for Surgery of the Alimentary Tract
Introduction Hepatic adenomas (HA) are rare, benign tumors commonly associated with oral contraceptive use in young women. Given their pre-malignant potential, many patients require regular surveillance. While some small adenomas may regress with cessation of oral contraceptives and weight loss, patients with larger tumors, symptoms, or elevated risk of tumor hemorrhage or malignant transformation may require invasive interventions including surgical resection or angiographic embolization.1 Current data regarding quality of life (QOL) among patients with HA are scarce. Because most of these patients are young and otherwise healthy, optimizing QOL among patients with HA and those who previously have undergone surgery is imperative. The purpose of this study, therefore, was to assess QOL among patients with HA using a validated cross-sectional tool administered via a social media platform.
Methods Members of two Facebook (Menlo Park, CA) diagnosis-based support groups were invited to participate in this crosssectional QOL study. Respondents were provided a link to an anonymous secure survey on a Redcap database. Selfreported de-identified demographic and clinical information were provided. QOL was assessed using the validated FACT-Hep instrument and compared with generalized US population scores.2, 3 For individuals who had undergone * Jordan M. Cloyd [email protected] 1
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner, 410 W 10th Ave, N907 Doan Hall, Columbus, OH 43210-1267, USA
surgery, a modified Patient-Reported Impact of Scars Measure (PRISM) questionnaire was administered.4
Results Of the 74 responses received, most individuals were female (97.3%), American (64.9%), and had a mean age of 38 (26– 58) years with a mean time interval of 2.56 (0–25) years since diagnosis. The most common treatment intervention was cessation of oral contraceptives (74.3%), while 44.6% of patients had undergone surgical resection, and 31.0% had a history of embolization or ablation. Among 33 patients who had undergone resection, mean follow-up time since diagnosis was 4.5 (0–20) years since the date of surgery; most individuals had undergone open surgery (66.7%) and were still under active surveillance (90.5%). With the exception of lower emotional well-being scores (EWB; 15.3 vs 18.7, p < 0.01), mean overall FACT-Hep scores among patients with HA were not different from normative scores of the general US population (Fig. 1). In addition, there were no differences in QOL between surgical and non-surgical patients (Fig. 1). Regarding physical symptoms, surgical patients more frequently reported abdominal cramping, loss of bowel control, and loss of taste compared with non-surgical patients (Fig. 2).
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