Eliciting Patient Preferences to Guide HCC Treatment Decisions

In an interview with CancerNetwork® at The Liver Meeting® 2026, Andrew Moon, MD, MPH, a transplant hepatologist and assistant professor of medicine in the Division of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill (UNC), explained what his research has revealed about the priorities of patients choosing among treatments for hepatocellular carcinoma (HCC).

Moon described how his qualitative work on symptoms after locoregional therapy shaped his later research on patient preferences. In that single-center study, all 26 patients interviewed a median of 26 days after treatment with chemoembolization, radioembolization, stereotactic body radiation therapy, or thermal ablation reported at least 1 physical symptom, most commonly appetite loss (73%), fatigue (58%), and abdominal pain (46%). Additionally, 77% of patients said they saw potential benefits in electronic symptom monitoring.

In later interviews with patients, caregivers, and clinicians, Moon found that patient goals often diverged from those of their care teams. He emphasized the value of formally eliciting patient preferences when choosing among HCC treatments.

Moon practices within the UNC Multidisciplinary HCC Clinic.

Transcript:

CancerNetwork: Your research focuses on patient preferences in HCC treatment. What have patients told you they value most when choosing between options like ablation, radiation, and surgery? What has surprised you?

Moon: A few things have surprised me. Before my work on preferences, I did some qualitative work looking at posttreatment symptoms, which informed the work on preferences. One thing I was surprised by is that after locoregional therapies, which we as providers often describe to patients as well tolerated, patients stated that they often had symptoms, and those symptoms often impaired their functioning. With these well-tolerated treatments, patients were saying, “I struggled more than you realize.” That informed how we should be talking about these treatments and how we should be looking at pretreatment symptom burden and how it will inform treatment choice. That launched my work on preferences.

I interviewed clinicians, patients, and caregivers. When I spoke to many experts in the field, there was a thought that our preferences are aligned—that what is important to providers is what is important to patients. For many patients, that is true. What surprised me was how often patients had goals that were not necessarily aligned with ours. It revealed to me how important it is to ask, “What is important to you? What do you value in your life when you look at this treatment? What do you want to accomplish? What do you want to avoid?” That qualitative work showed me the importance of formal elicitation of patient preferences as part of our treatment of HCC.

Reference

Moon AM, Cook S, Swier RM, et al. Patient-reported symptoms and interest in symptom monitoring in HCC treated with locoregional therapies: a qualitative study. Hepatol Commun. 2023;7(11):e0315. doi:10.1097/HC9.0000000000000315