Postoperative health-related Quality of Life after liver resection

ABSTRACT Background and Aim Liver resection remains the primary therapeutic strategy for various liver tumors. Optimal surgical outcomes depend on preoperative assessment. However, there is limited evidence regarding patients’ quality of life (QoL) in the postoperative course. This study aimed to evaluate postoperative QoL in patients who underwent liver resection to identify patient- and disease-related factors influencing these outcomes. Methods This prospective single-center observational study assessed patients who received elective liver resection for hepatobiliary diseases in 2022. QoL was assessed preoperatively and six months postoperatively using the Short Form-36 (SF-36) Health Survey, which comprises eight domains and two composite scores. Exploratory univariable and multivariable analyses were conducted to assess factors associated with postoperative QoL. In addition, baseline-adjusted sensitivity analyses using a fixed covariate set were performed in patients with malignant disease. Results A total of 83 patients were eligible for the final analysis. Of these, 14 patients (16.9%) had benign lesions, 32 (38.6%) had primary malignant tumors, and 37 (44.6%) had secondary malignant tumors. Exploratory multivariable analyses showed associations between postoperative QoL and several patient-, disease-, and treatment-related factors with a mean R2 of 0.28 across the ten models. In baseline-adjusted sensitivity analyses restricted to patients with malignant disease, the corresponding preoperative SF-36 score was significantly associated with postoperative QoL in all ten models. After FDR correction, tumor recurrence remained significantly associated with lower RP, GH, VT, SF, RE, MH and MCS scores. Conclusion Postoperative QoL after liver resection is influenced by patient-, disease- and treatment-related factors. Tumor recurrence, postoperative morbidity and readmission are associated with impaired recovery, highlighting the importance of complication prevention, structured follow-up and supportive care.