Health-Related Quality of Life in Patients with Hepatocellular Carcinoma Post-Surgery: A Scoping Review.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. While surgical treatments, including liver resection and transplantation, offer curative potential, they significantly impact patients' health-related quality of life (HRQoL). This scoping review aims to comprehensively map the existing literature on HRQoL following surgical treatment for HCC by identifying commonly used assessment tools, variations across surgical approaches, and key influencing factors. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science from inception to February 2025, adhering to the Joanna Briggs Institute (JBI) Scoping Review methodology and the PRISMA-ScR checklist. Studies were included if they assessed post-operative HRQoL in HCC patients using validated instruments. Two independent reviewers screened, selected, and extracted data from eligible studies. Results: Of the 1,275 articles retrieved, 13 met the inclusion criteria. Sample sizes ranged from 66 to 332, with studies included conducted in the USA, China, Germany, Spain, Egypt, and Japan. The most frequently used HRQoL assessment tools were SF-36, FACT-Hep, and EORTC QLQ-C30. Findings revealed an initial decline in HRQoL postoperatively, followed by gradual recovery over 3-12 months. Liver transplantation generally resulted in substantial long-term HRQoL compared to liver resection, although challenges associated with immunosuppressive therapy persisted. Key factors influencing HRQoL included preoperative depression, post-operative complications, disease recurrence, and socioeconomic variables such as age, gender, and family support. Conclusions: Post-operative HRQoL in HCC patients follows a dynamic trajectory, which emphasizes the need for patient-centered care strategies. Standardized HRQoL assessments and longitudinal studies are crucial for enabling cross-study comparisons and guiding targeted interventions to optimize recovery and long-term well-being.