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A systematic review of health-related quality of life instruments in patients with cancer cachexia

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Abstract

Purpose

Assessing the health-related quality of life (HRQOL) of cancer patients with cachexia is particularly important because treatments for cachexia are currently aimed at palliation and treatment efficacy must be measured in ways other than survival. The aim of this systematic review was to evaluate HRQOL assessment in cancer patients with cachexia.

Methods

Using guidance from the Centre for Reviews and Dissemination, relevant databases were searched from January 1980 to January 2012 with terms relating to cancer, cachexia and HRQOL for papers including adult cancer patients with cachexia or documented weight loss at baseline.

Results

We found one cachexia-specific instrument, the Functional Assessment of Anorexia/Cachexia Therapy, but the tool has not been fully validated, does not cover all the relevant domains and the consensus-based standards for the selection of health status measurement instruments checklist highlighted a number of weaknesses in the methodological quality of the validation study. Sixty-seven studies assessed HRQOL in cachectic or weight-losing cancer patients. Most used generic cancer HRQOL instruments, limiting the amount of useful information they provide. A modified version of the Efficace minimum data checklist demonstrated that the quality of reporting on HRQOL tool use was inadequate in many of the studies. A negative relationship between HRQOL and weight loss was found in 23 of the 27 studies which directly examined this.

Conclusion

There is a pressing need for a well-designed HRQOL tool for use with this patient group in both clinical trials and clinical practice.

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Acknowledgments

This work was made possible through funding from the European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QOL) Group.

Conflict of interest

There is no conflict of interest to declare. No primary data were used for this paper, but the authors agree to allow the journal to review any secondary analysis carried out.

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Authors and Affiliations

  1. Cancer Sciences, University of Southampton, Southampton, UK

    Sally Wheelwright, Alice White & Colin D. Johnson

  2. Health Sciences, University of Southampton, Southampton, UK

    Anne-Sophie Darlington

  3. Cardiff School of Nursing and Midwifery Studies, School of Biomedical and Life Sciences, Cardiff University, Cardiff, UK

    Jane B. Hopkinson

  4. Swansea Centre for Health Economics, Swansea University, Swansea, UK

    Deborah Fitzsimmons

  5. University Surgical Unit (MP 816), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK

    Sally Wheelwright

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  1. Sally Wheelwright
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  2. Anne-Sophie Darlington
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  4. Deborah Fitzsimmons
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  5. Alice White
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Correspondence to Sally Wheelwright.

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Wheelwright, S., Darlington, AS., Hopkinson, J.B. et al. A systematic review of health-related quality of life instruments in patients with cancer cachexia. Support Care Cancer 21, 2625–2636 (2013). https://doi.org/10.1007/s00520-013-1881-9

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