1
|
Chung KC, Muthutantri A, Goldsmith GG, Watts MR, Brown AE, Patrick DL. Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: a narrative literature review. BMC Cancer 2024; 24:884. [PMID: 39039461 PMCID: PMC11265440 DOI: 10.1186/s12885-024-12612-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Cancer stage at diagnosis is an important prognostic indicator for patient outcomes, with detection at later stages associated with increased mortality and morbidity. The impact of cancer stage on patient-reported outcomes is poorly understood. This research aimed to understand symptom burden and health related quality of life (HRQoL) impact by cancer stage for ten cancer types: 1) ovarian, 2) lung, 3) pancreatic, 4) esophageal, 5) stomach, 6) head and neck, 7) colorectal, 8) anal, 9) cervical, and 10) liver and bile duct. METHODS Ten narrative literature reviews were performed to identify and collate published literature on patient burden at different stages of disease progression. Literature searches were conducted using an AI-assisted platform to identify relevant articles published in the last five (2017-2022) or ten years (2012-2022) where articles were limited. Conference abstracts were searched for the last two years (2020-2022). The geographic scope was limited to the United States, Canada, Europe, and global studies, and only journal articles written in English were included. RESULTS A total of 26 studies with results stratified by cancer stage at diagnosis (and before treatment) were selected for the cancer types of lung, pancreatic, esophageal, stomach, head and neck, colorectal, anal, and cervical cancers. Two cancer types, ovarian cancer, and liver and bile duct cancer did not return any search results with outcomes stratified by disease stage. A general trend was observed for worse patient-reported outcomes in patients with cancer diagnosed at an advanced stage of disease compared with diagnosis at an earlier stage. Advanced disease stage was associated with greater symptom impact including general physical impairments such as pain, fatigue, and interference with functioning, as well as disease/region-specific symptom burden. Poorer HRQoL was also associated with advanced disease with commonly reported symptoms including anxiety and depression. CONCLUSIONS Overall, the general trend for greater symptom burden and poorer HRQoL seen in late stage versus early-stage disease across the included cancer types supports the importance for early diagnosis and treatment to improve patient survival and decrease negative impacts on disease burden and HRQoL.
Collapse
Affiliation(s)
- Karen C Chung
- GRAIL, Inc., 1525 O'Brien Dr, Menlo Park, CA, 94025, USA.
| | | | - Grace G Goldsmith
- Genesis Research Group, West One, Forth Banks, Newcastle upon Tyne, NE1 3PA, UK
| | - Megan R Watts
- Genesis Research Group, West One, Forth Banks, Newcastle upon Tyne, NE1 3PA, UK
| | - Audrey E Brown
- Genesis Research Group, West One, Forth Banks, Newcastle upon Tyne, NE1 3PA, UK
| | - Donald L Patrick
- University of Washington, 1959 NE Pacific St, Box 357660, Seattle, WA, 98195, USA
| |
Collapse
|
2
|
Lehner U, Zaretsky E, Goeze A, Wermter L, Stuck BA, Birk R, Neff A, Fischer I, Ghanaati S, Sader R, Hey C. [Pre-treatment dysphagia in head-and-neck cancer patients]. HNO 2022; 70:533-539. [PMID: 35122104 PMCID: PMC9242961 DOI: 10.1007/s00106-021-01128-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND The swallowing and nutritional status of head-and-neck cancer patients after oncological therapy have been extensively researched. However, the same topics are seldom scrutinized before the onset of oncological therapy, although they can influence treatment success in the long term. OBJECTIVE This study focusses on a systematic assessment of swallowing function and nutritional status in head-and-neck cancer patients prior to oncological therapy. MATERIALS AND METHODS In 102 patients, penetration/aspiration (PA scale), limitations of oral intake (Functional Oral Intake Scale, FOIS), and the need for further intervention (NFI) were endoscopically assessed to objectively quantify swallowing function. The subjective evaluation of swallowing function was carried out with the gEAT-10 (German EAT-10) questionnaire, nutritional status was assessed by body mass index (BMI). Possible impact factors for swallowing function and BMI were analyzed by univariate and multivariate methods. RESULTS PAS, FOIS, and NFI values were abnormal in ≤ 15% of patients. BMI was more often too high than too low. Objectively assessed swallowing functions depended predominantly on tumor stage and showed moderate correlations with gEAT-10. The latter mostly yielded a "fail" result. The nutritional status depended on the patients' biological sex and NFI. CONCLUSION In the pre-treatment setting, neither dysphagia nor malnutrition were found in most patients. Impaired swallowing was associated with higher tumor stages, malnutrition with female sex and NFI. A systematic pre-treatment assessment of swallowing and nutritional status in head-and-neck cancer patients appears necessary for modern oncological therapy and optimal patient outcome.
Collapse
Affiliation(s)
- Uta Lehner
- Abteilung für Phoniatrie und Pädaudiologie, HNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland
| | - Eugen Zaretsky
- Abteilung für Phoniatrie und Pädaudiologie, HNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland.
| | - Almut Goeze
- Abteilung für Phoniatrie und Pädaudiologie, HNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland
| | - Laura Wermter
- Abteilung für Phoniatrie und Pädaudiologie, HNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland
| | - Boris A Stuck
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Richard Birk
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Andreas Neff
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Ingo Fischer
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Shahram Ghanaati
- Klinik für Mund‑, Kiefer‑, Plastische Gesichtschirurgie, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt/Main, Deutschland
| | - Robert Sader
- Klinik für Mund‑, Kiefer‑, Plastische Gesichtschirurgie, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt/Main, Deutschland
| | - Christiane Hey
- Abteilung für Phoniatrie und Pädaudiologie, HNO, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland
| |
Collapse
|
3
|
Goeze A, Zaretsky E, Lehner U, Wermter L, Mayer M, Stuck BA, Birk R, Neff A, Fisher I, Stöver T, Kramer S, Ghanaati S, Sader R, Hey C. [Post-operative prevalence of dysphagia in head-and-neck cancer patients in the acute care units]. Laryngorhinootologie 2021; 101:320-326. [PMID: 34187052 DOI: 10.1055/a-1528-7584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Dysphagia constitutes a frequent post-operative functional impairment in head-and-neck cancer patients. This impairment can result in aspiration/penetration and limitations of oral intake. Therefore, often it requires a therapeutic intervention. In this study, prevalence of post-operative dysphagia and its associations with the tumour stage, localisation, patients' age, and biological sex were analysed for the inpatient treatment setting. MATERIAL AND METHODS A total of 201 adult head-and-neck cancer patients (mean age 63 years) were analysed prospectively by FEES in two university hospitals in regard to their penetration/aspiration, limitations of oral intake, and need for therapeutic interventions directly after the operative tumour treatment. Additionally, the influence of the same patients' characteristics on these three parameters were analysed by means of univariate and multivariate statistical methods. RESULTS Out of 201 patients, 66.7 % needed a therapeutic intervention because of their dysphagia, 57.2 % needed a nasogastral or PEG tube due to limitations of oral intake, 45.3 % had an aspiration. In the latter subgroup, 38.5 % had a silent aspiration. Higher tumour stage, patients' higher age and male sex were shown to be significant influence factors for dysphagia, tumour localisation showed only a marginally significant result. CONCLUSIONS The study demonstrated a clinical importance and relevance of the consequent and systematic treatment of post-operative dysphagia in head-and-neck cancer patients in the acute care units as a constituent of a modern oncological therapy.
Collapse
Affiliation(s)
- Almut Goeze
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Eugen Zaretsky
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Uta Lehner
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Laura Wermter
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Miriam Mayer
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Boris A Stuck
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Richard Birk
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Andreas Neff
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Ingo Fisher
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| | - Timo Stöver
- Klinik für HNO-Heilkunde, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt, Deutschland
| | - Sabine Kramer
- Schwerpunkt für Phoniatrie und Pädaudiologie, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt am Main, Deutschland
| | - Shahram Ghanaati
- Klinik für Mund-, Kiefer-, Plastische Gesichtschirurgie, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt am Main, Deutschland
| | - Robert Sader
- Klinik für Mund-, Kiefer-, Plastische Gesichtschirurgie, Universitätsklinikum Frankfurt/Main, Goethe-Universität Frankfurt/Main, Frankfurt am Main, Deutschland
| | - Christiane Hey
- Abt. für Phoniatrie und Pädaudiologie, KHNO,Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Philipps-Universität Marburg, Deutschland
| |
Collapse
|