Health-related Quality of Life in Primary Hepatic Cancer: a Systematic Review Assessing the Methodological Properties of Instruments and a Meta-analysis Comparing Treatment Strategies

Overview

Journal Qual Life Res

Specialties Pharmacology
Rehabilitation Medicine

Date 2021 Jul 20

PMID 34283381

Citations 5

Authors

Kerstin Wohlleber

Patrick Heger

Pascal Probst

Christoph Engel

Markus K Diener

Andre L Mihaljevic

Affiliations

Soon will be listed here.

Abstract

Purpose: Patient-reported outcomes including health-related quality of life (HRQoL) are important oncological outcome measures. The validation of HRQoL instruments for patients with hepatocellular and cholangiocellular carcinoma is lacking. Furthermore, studies comparing different treatment options in respect to HRQoL are sparse. The objective of the systematic review and meta-analysis was, therefore, to identify all available HRQoL tools regarding primary liver cancer, to assess the methodological quality of these HRQoL instruments and to compare surgical, interventional and medical treatments with regard to HRQoL.

Methods: A systematic literature search was conducted in MEDLINE, the Cochrane library, PsycINFO, CINAHL and EMBASE. The methodological quality of all identified HRQoL instruments was performed according to the COnsensus-based Standards for the selection of health status Measurements INstruments (COSMIN) standard. Consequently, the quality of reporting of HRQoL data was assessed. Finally, wherever possible HRQoL data were extracted and quantitative analyses were performed.

Results: A total of 124 studies using 29 different HRQoL instruments were identified. After the methodological assessment, only 10 instruments fulfilled the psychometric criteria and could be included in subsequent analyses. However, quality of reporting of HRQoL data was insufficient, precluding meta-analyses for 9 instruments.

Conclusion: Using a standardized methodological assessment, specific HRQoL instruments are recommended for use in patients with hepatocellular and cholangiocellular carcinoma. HRQoL data of patients undergoing treatment of primary liver cancers are sparse and reporting falls short of published standards. Meaningful comparison of established treatment options with regard to HRQoL was impossible indicating the need for future research.

Citing Articles

Gastrointestinal side effects in hepatocellular carcinoma patients receiving transarterial chemoembolization: a meta-analysis of 81 studies and 9495 patients.

Arendt N, Kopsida M, Khaled J, Sjoblom M, Heindryckx F Ther Adv Med Oncol. 2025; 17:17588359251316663.

PMID: 39926261 PMC: 11806495. DOI: 10.1177/17588359251316663.

Methodological quality of 100 recent systematic reviews of health-related outcome measurement instruments: an overview of reviews.

Elsman E, Mokkink L, Abma I, Aiyegbusi O, Chiarotto A, Haywood K Qual Life Res. 2024; 33(10):2593-2609.

PMID: 38961010 PMC: 11452433. DOI: 10.1007/s11136-024-03706-z.

Modular multimodal hospital-home chain physical activity rehabilitation programme (3M2H-PARP) in liver cancer: a protocol for a randomised controlled trial.

Chen H, Lu H, Zhou H, Wu B, Dong Z, Zhang S BMJ Open. 2024; 14(5):e083228.

PMID: 38772899 PMC: 11110592. DOI: 10.1136/bmjopen-2023-083228.

Development of a Patient-Reported Symptom Item Bank for Patients with Hepatobiliary or Pancreatic Malignancies: A Systematic Review.

Zhang J, Zhan Y, Chen J, Kang D, Xiang R, Zhang R Patient Prefer Adherence. 2023; 17:199-207.

PMID: 36698859 PMC: 9869794. DOI: 10.2147/PPA.S398666.

Inverse Probability of Treatment Weighting in 5-Year Quality-of-Life Comparison among Three Surgical Procedures for Hepatocellular Carcinoma.

Chang D, Chen Y, Chen H, Chiu C, Lee K, Wang J Cancers (Basel). 2023; 15(1).

PMID: 36612245 PMC: 9818414. DOI: 10.3390/cancers15010252.

References

Vilgrain V, Pereira H, Assenat E, Guiu B, Ilonca A, Pageaux G . Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2017; 18(12):1624-1636. DOI: 10.1016/S1470-2045(17)30683-6. View

Casanovas T, Jane L, Herdman M, Casado A, Garcia B, Prat B . Assessing outcomes in liver disease patients: reliability and validity of the Spanish version of the Liver Disease Quality of Life Questionnaire (LDQOL 1.0). Value Health. 2010; 13(4):455-62. DOI: 10.1111/j.1524-4733.2009.00688.x. View

Cao W, Li J, Hu C, Shen J, Liu X, Xu Y . Symptom clusters and symptom interference of HCC patients undergoing TACE: a cross-sectional study in China. Support Care Cancer. 2012; 21(2):475-83. DOI: 10.1007/s00520-012-1541-5. View

Chung M, Wang S, Lin C . Symptom Clusters and Impact of Fatigue and Sleep Disturbance on Symptom Experiences of Hepatoma Patients in Taiwan. Cancer Nurs. 2016; 40(5):403-411. DOI: 10.1097/NCC.0000000000000417. View

Steel J, Chopra K, Olek M, Carr B . Health-related quality of life: Hepatocellular carcinoma, chronic liver disease, and the general population. Qual Life Res. 2006; 16(2):203-15. DOI: 10.1007/s11136-006-9111-2. View

Lee L, Chen C, Yao G, Chung C, Sheu J, Lee P . Quality of life in patients with hepatocellular carcinoma received surgical resection. J Surg Oncol. 2006; 95(1):34-9. DOI: 10.1002/jso.20374. View

McGrail K, Bryan S, Davis J . Let's all go to the PROM: the case for routine patient-reported outcome measurement in Canadian healthcare. Healthc Pap. 2012; 11(4):8-18. DOI: 10.12927/hcpap.2012.22697. View

Huang G, Chen X, Lau W, Shen F, Wang R, Yuan S . Quality of life after surgical resection compared with radiofrequency ablation for small hepatocellular carcinomas. Br J Surg. 2014; 101(8):1006-15. DOI: 10.1002/bjs.9539. View

Ye X, Lu D, Chen X, Li S, Chen Y, Deng L . A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Shuangbai San for Treating Primary Liver Cancer Patients With Cancer Pain. J Pain Symptom Manage. 2016; 51(6):979-86. DOI: 10.1016/j.jpainsymman.2015.12.330. View

10.

Llovet J, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc J . Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008; 359(4):378-90. DOI: 10.1056/NEJMoa0708857. View

11.

Bosetti C, Turati F, La Vecchia C . Hepatocellular carcinoma epidemiology. Best Pract Res Clin Gastroenterol. 2014; 28(5):753-70. DOI: 10.1016/j.bpg.2014.08.007. View

12.

Hsu W, Tsai A, Chan S, Wang P, Chung N . Mini-nutritional assessment predicts functional status and quality of life of patients with hepatocellular carcinoma in Taiwan. Nutr Cancer. 2012; 64(4):543-9. DOI: 10.1080/01635581.2012.675620. View

13.

Liu J, Wang Y, Zhang D, Liu B, Ou Q . Comparison of survival and quality of life of hepatectomy and thrombectomy using total hepatic vascular exclusion and chemotherapy alone in patients with hepatocellular carcinoma and tumor thrombi in the inferior vena cava and hepatic vein. Eur J Gastroenterol Hepatol. 2011; 24(2):186-94. DOI: 10.1097/MEG.0b013e32834dda64. View

14.

Tian H, Li H, Wang B, Liang G, Huang X, Huang Z . Treatment of middle/late stage primary hepatic carcinoma by Chinese medicine comprehensive therapy: A prospective randomized controlled study. Chin J Integr Med. 2010; 16(2):102-8. DOI: 10.1007/s11655-010-0102-3. View

15.

Nojiri S, Fujiwara K, Shinkai N, Iio E, Joh T . Effects of branched-chain amino acid supplementation after radiofrequency ablation for hepatocellular carcinoma: A randomized trial. Nutrition. 2016; 33:20-27. DOI: 10.1016/j.nut.2016.07.013. View

16.

Brans B, Lambert B, De Beule E, De Winter F, Van Belle S, Van Vlierberghe H . Quality of life assessment in radionuclide therapy: a feasibility study of the EORTC QLQ-C30 questionnaire in palliative (131)I-lipiodol therapy. Eur J Nucl Med Mol Imaging. 2002; 29(10):1374-9. DOI: 10.1007/s00259-002-0918-y. View

17.

Zhu Z, Lang Q, Chen Z, Li D, Ling C . [Evaluation of Chinese version of the Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire]. Zhong Xi Yi Jie He Xue Bao. 2008; 6(4):341-5. DOI: 10.3736/jcim20080403. View

18.

Zhou K, Zhang M, Wu Q, Ji Z, Zhang X, Zhuang G . Reliability, validity and sensitivity of the Chinese (simple) short form 36 health survey version 2 (SF-36v2) in patients with chronic hepatitis B. J Viral Hepat. 2013; 20(4):e47-55. DOI: 10.1111/jvh.12030. View

19.

Shun S, Chiou J, Lai Y, Yu P, Wei L, Tsai J . Changes in quality of life and its related factors in liver cancer patients receiving stereotactic radiation therapy. Support Care Cancer. 2008; 16(9):1059-65. DOI: 10.1007/s00520-007-0384-y. View

20.

Dimitroulopoulos D, Xinopoulos D, Tsamakidis K, Zisimopoulos A, Andriotis E, Panagiotakos D . Long acting octreotide in the treatment of advanced hepatocellular cancer and overexpression of somatostatin receptors: randomized placebo-controlled trial. World J Gastroenterol. 2007; 13(23):3164-70. PMC: 4436600. DOI: 10.3748/wjg.v13.i23.3164. View