Systematic review reveals limitations of studies evaluating health-related quality of life after potentially curative treatment for esophageal cancer

Purpose: To (1) assess the quality of studies evaluating Health-Related Quality of Life (HRQL) after potentially curative treatment for esophageal cancer, and (2) to identify high-quality studies that provide robust HRQL results. Methods: A systematic literature search is to identify studies evaluating HRQL with a validated multidimensional patient-reported outcome measure. Study quality focused on study design, risk of bias, HRQL outcome reporting, and additional issues of reporting and methodology. A study was deemed high-quality if criteria for robust study methodology and robust HRQL outcome reporting were met. Results: Six RCTs, 12 cohort studies, 13 case-series, and 31 cross-sectional studies were identified. Overall risk of bias was high. Reporting of HRQL concept (e.g.; a priori hypothesis), methodology (e.g.; reasons for missing data), and interpretation (e.g.; clinical significance) was often absent or unclear. Additional issues of reporting (e.g.; unclear treatment descriptions) and methodology (e.g.; no control for multiple testing) were identified. Four studies (6 %) met the criteria for robust study methodology, and 26 studies (42 %) met the criteria for robust HRQL outcome reporting. We identified three high-quality studies (5 %) - two RCTs and one case-series - capable of providing robust results. Conclusions: Current evidence is restricted in its ability to inform practice on HRQL after potentially curative treatment for esophageal cancer.

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