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      Clinical efficacy of comprehensive rehabilitation intervention and its effect on Quality of Life in patients with Advanced Liver Cancer after Ultrasound-guided Microwave Ablation

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          Abstract

          Objective:

          To evaluate the clinical efficacy of comprehensive rehabilitation intervention and its effect on the quality of life (QoL) in patients with advanced liver cancer after ultrasound-guided microwave ablation (UMA).

          Methods:

          This is a retrospective study. Total 110 in-patients with advanced liver cancer who had received UMA in our hospital from January 2019 to January 2021 were included and randomly divided into two groups. Patients in the control group received the conventional intervention and those in the experimental group received comprehensive rehabilitation intervention. The incidence of postoperative complications as well as the differences in indicators, including emotional status, QoL score, and patient satisfaction before and after the intervention were analyzed and compared between the two groups. The differences in survival between the two groups were compared.

          Results:

          The incidence of postoperative complications in the experimental group was significantly lower than that of the control group. SAS and SDS scores of the experimental group were significantly decreased after intervention, while the control group had no significant change before and after intervention. KPS and SF-36 quality of life scores in the experimental group were significantly improved compared with the control group, and patient satisfaction was significantly higher than the control group, and the 12-month survival rate was significantly higher than that in the control group.

          Conclusion:

          Comprehensive rehabilitation intervention can reduce the incidence of postoperative complications, improve the mood and QoL, and increase patient satisfaction and survival rate in patients with advanced liver cancer after UMA.

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          Most cited references27

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          A global view of hepatocellular carcinoma: trends, risk, prevention and management

          Ju Yang, Pierre Hainaut, Gregory J. Gores … (2019)
          Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Risk factors for HCC include chronic hepatitis B and hepatitis C, alcohol addiction, metabolic liver disease (particularly nonalcoholic fatty liver disease) and exposure to dietary toxins such as aflatoxins and aristolochic acid. All these risk factors are potentially preventable, highlighting the considerable potential of risk prevention for decreasing the global burden of HCC. HCC surveillance and early detection increase the chance of potentially curative treatment; however, HCC surveillance is substantially underutilized, even in countries with sufficient medical resources. Early-stage HCC can be treated curatively by local ablation, surgical resection or liver transplantation. Treatment selection depends on tumour characteristics, the severity of underlying liver dysfunction, age, other medical comorbidities, and available medical resources and local expertise. Catheter-based locoregional treatment is used in patients with intermediate-stage cancer. Kinase and immune checkpoint inhibitors have been shown to be effective treatment options in patients with advanced-stage HCC. Together, rational deployment of prevention, attainment of global goals for viral hepatitis eradication, and improvements in HCC surveillance and therapy hold promise for achieving a substantial reduction in the worldwide HCC burden within the next few decades.
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            Challenges in liver cancer and possible treatment approaches

            David Anwanwan, Santosh Kumar Singh, Shriti Singh … (2020)
            Globally, liver cancer is the most frequent fatal malignancy; in the United States, it ranks fifth. Patients are often diagnosed with liver cancer in advanced stages, contributing to its poor prognosis. Of all liver cancer cases, >90% are hepatocellular carcinomas (HCCs) for which chemotherapy and immunotherapy are the best options for therapy. For liver cancer patients, new treatment options are necessary. Use of natural compounds and/or nanotechnology may provide patients with better outcomes with lower systemic toxicity and fewer side effects. Improved treatments can lead to better prognoses. Finally, in this review, we present some of the problems and current treatment options contributing to the poor outcomes for patients with liver cancer.
            Article 0 comments Cited 410 times – based on 0 reviews     Review now
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              Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update

              Francesco Izzo, Vincenza Granata, Roberto Grassi … (2019)
              A review of the literature on the safety and efficacy of radiofrequency ablation and microwave ablation on the liver was conducted. This article summarizes the results, focusing on treatment of primary liver tumors and hepatic metastasis. This article provides an overview of radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of primary liver tumors and hepatic metastasis. Only studies reporting RFA and MWA safety and efficacy on liver were retained. We found 40 clinical studies that satisfied the inclusion criteria. RFA has become an established treatment modality because of its efficacy, reproducibility, low complication rates, and availability. MWA has several advantages over RFA, which may make it more attractive to treat hepatic tumors. According to the literature, the overall survival, local recurrence, complication rates, disease‐free survival, and mortality in patients with hepatocellular carcinoma (HCC) treated with RFA vary between 53.2 ± 3.0 months and 66 months, between 59.8% and 63.1%, between 2% and 10.5%, between 22.0 ± 2.6 months and 39 months, and between 0% and 1.2%, respectively. According to the literature, overall survival, local recurrence, complication rates, disease‐free survival, and mortality in patients with HCC treated with MWA (compared with RFA) vary between 22 months for focal lesion >3 cm (vs. 21 months) and 50 months for focal lesion ≤3 cm (vs. 27 months), between 5% (vs. 46.6%) and 17.8% (vs. 18.2%), between 2.2% (vs. 0%) and 61.5% (vs. 45.4%), between 14 months (vs. 10.5 months) and 22 months (vs. no data reported), and between 0% (vs. 0%) and 15% (vs. 36%), respectively. According to the literature, the overall survival, local recurrence, complication rates, and mortality in liver metastases patients treated with RFA (vs. MWA) are not statistically different for both the survival times from primary tumor diagnosis and survival times from ablation, between 10% (vs. 6%) and 35.7% (vs. 39.6), between 1.1% (vs. 3.1%) and 24% (vs. 27%), and between 0% (vs. 0%) and 2% (vs. 0.3%). MWA should be considered the technique of choice in selected patients, when the tumor is ≥3 cm in diameter or is close to large vessels, independent of its size. Although technical features of the radiofrequency ablation (RFA) and microwave ablation (MWA) are similar, the differences arise from the physical phenomenon used to generate heat. RFA has become an established treatment modality because of its efficacy, reproducibility, low complication rates, and availability. MWA has several advantages over RFA, which may make it more attractive than RFA to treat hepatic tumors. The benefits of MWA are an improved convection profile, higher constant intratumoral temperatures, faster ablation times, and the ability to use multiple probes to treat multiple lesions simultaneously. MWA should be considered the technique of choice when the tumor is ≥3 cm in diameter or is close to large vessels, independent of its size.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (iso-abbrev): Pak J Med Sci
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): May-Jun 2023
                Volume: 39
                Issue: 3
                Pages: 809-814
                Affiliations
                [1 ]Dan Chen, Interventional Ultrasound Department, Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, P. R. China
                [2 ]Fan Yang, Department of Medical Oncology, Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, P. R. China
                [3 ]Xiu-ju Wang, Department of Medical Oncology, Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, P. R. China
                [4 ]Jing Zhao, Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, P. R. China
                Author notes
                Correspondence: Jing Zhao, Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, P. R. China. Email: chendan20212022@ 123456126.com
                Article
                Publisher ID: PJMS-39-809
                DOI: 10.12669/pjms.39.3.6663
                PMC ID: 10214812
                SO-VID: 9a3d2456-c84e-4d98-b764-35d77a088e70
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 02 March 2022
                Date revision received : 16 April 2022
                Date revision received : 08 February 2023
                Date accepted : 28 February 2023
                Categories
                Subject: Original Article

                Keywords: rehabilitation,liver neoplasms,quality of life,complications
                Data availability:
                Keywords: rehabilitation, liver neoplasms, quality of life, complications

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