背景:诊断时的癌症分期是患者预后的重要预后指标,后期检测与死亡率和发病率增加有关。癌症分期对患者报告结果的影响知之甚少。本研究旨在了解症状负担和健康相关的生活质量(HRQoL)的影响,癌症分期为10种癌症类型:1)卵巢癌,2)肺,3)胰腺,4)食道,5)胃,6)头部和颈部,7)结直肠,8)肛门,9)宫颈,和10)肝脏和胆管。
方法:进行了10篇叙述性文献综述,以确定和整理已发表的关于疾病进展不同阶段患者负担的文献。使用AI辅助平台进行文献检索,以识别过去五年(2017-2022年)或十年(2012-2022年)中文章有限的相关文章。搜索了过去两年(2020-2022年)的会议摘要。地理范围仅限于美国,加拿大,欧洲,和全球研究,只包括用英语写的期刊文章。
结果:共有26项研究的结果按诊断时(和治疗前)的癌症分期进行了分层,胰腺,食道,胃,头部和颈部,结直肠,肛门,和宫颈癌。两种癌症类型,卵巢癌,肝癌和胆管癌没有返回任何按疾病分期分层的检索结果.与早期诊断相比,在疾病晚期诊断的癌症患者中观察到患者报告的结果更差的总体趋势。晚期疾病阶段与更大的症状影响相关,包括一般的身体损伤,如疼痛,疲劳,干扰功能,以及疾病/地区特定的症状负担。较差的HRQoL也与晚期疾病相关,通常报告的症状包括焦虑和抑郁。
结论:总体而言,在所纳入的癌症类型中,晚期疾病与早期疾病相比症状负担更大,HRQoL更差的总体趋势支持了早期诊断和治疗对于提高患者生存率和减少对疾病负担和HRQoL的负面影响的重要性.
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.