Evaluating the effect of upper-body morbidity on quality of life following primary breast cancer treatment: a systematic review and meta-analysis.

IF 3.1 2区医学 Q2 ONCOLOGY Journal of Cancer Survivorship Pub Date : 2024-10-01 Epub Date: 2023-05-18 DOI:10.1007/s11764-023-01395-0

Eliza R Macdonald, Nadia M L Amorim, Amanda D Hagstrom, Katarina Markovic, David Simar, Rachel E Ward, Briana K Clifford

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Abstract

Purpose: Improvements in breast cancer management continue to increase survival and life expectancy after treatment. Yet the adverse effects of treatment may persist long term, threatening physical, psychological, and social wellbeing, leading to impaired quality of life (QOL). Upper-body morbidity (UBM) such as pain, lymphoedema, restricted shoulder range of motion (ROM), and impaired function are widely reported after breast cancer treatment, but evidence demonstrating its impact on QOL is inconsistent. Therefore, the aim of the study was to conduct a systematic review and meta-analysis evaluating the effect of UBM on QOL following primary breast cancer treatment.

Methods: The study was prospectively registered on PROSPERO (CRD42020203445). CINAHL, Embase, Emcare, PsycInfo, PubMed/Medline, and SPORTDiscus databases were searched for studies reporting QOL in individuals with and without UBM following primary breast cancer treatment. Primary analysis determined the standardised mean difference (SMD) in physical, psychological, and social wellbeing scores between UBM + /UBM - groups. Secondary analyses identified differences in QOL scores between groups, according to questionnaire.

Results: Fifty-eight studies were included, with 39 conducive to meta-analysis. Types of UBM included pain, lymphoedema, restricted shoulder ROM, impaired upper-body function, and upper-body symptoms. UBM + groups reported poorer physical (SMD = - 0.99; 95%CI = - 1.26, - 0.71; p < 0.00001), psychological (SMD = - 0.43; 95%CI = - 0.60, - 0.27; p < 0.00001), and social wellbeing (SMD = - 0.62; 95%CI = - 0.83, - 0.40; p < 0.00001) than UBM - groups. Secondary analyses according to questionnaire showed that UBM + groups rated their QOL poorer or at equal to, UBM - groups across all domains.

Conclusions: Findings demonstrate the significant, negative impact of UBM on QOL, pervading physical, psychological, and social domains.

Implications for cancer survivors: Efforts to assess and minimise the multidimensional impact of UBM are warranted to mitigate impaired QOL after breast cancer.

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评估原发性乳腺癌治疗后上半身发病率对生活质量的影响：系统综述和荟萃分析。

目的：乳腺癌治疗方法的改进不断提高了患者的生存率和预期寿命。然而，治疗的不良影响可能会长期存在，威胁患者的身体、心理和社会福祉，导致生活质量（QOL）下降。乳腺癌治疗后，疼痛、淋巴水肿、肩部活动范围（ROM）受限和功能受损等上半身发病率（UBM）被广泛报道，但证明其对 QOL 影响的证据并不一致。因此，本研究旨在对 UBM 对原发性乳腺癌治疗后 QOL 的影响进行系统回顾和荟萃分析：该研究在 PROSPERO（CRD42020203445）上进行了前瞻性注册。在 CINAHL、Embase、Emcare、PsycInfo、PubMed/Medline 和 SPORTDiscus 数据库中检索了报告原发性乳腺癌治疗后 UBM 患者和未 UBM 患者 QOL 的研究。主要分析确定了 UBM + /UBM - 组间身体、心理和社会福利评分的标准化平均差 (SMD)。二次分析根据调查问卷确定各组间 QOL 评分的差异：结果：共纳入 58 项研究，其中 39 项有助于进行荟萃分析。UBM 的类型包括疼痛、淋巴水肿、肩关节活动受限、上半身功能受损和上半身症状。UBM + 组的身体状况较差（SMD = - 0.99; 95%CI = - 1.26, - 0.71; p 结论：研究结果表明，UBM 对患者的 QOL 有着重大的负面影响，影响范围涉及身体、心理和社会领域：对癌症幸存者的启示：有必要努力评估并尽量减少UBM的多方面影响，以减轻乳腺癌后QOL受损的情况。

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来源期刊

Journal of Cancer Survivorship ONCOLOGY-

CiteScore

7.00

自引率

10.80%

发文量

149

审稿时长

>12 weeks

期刊介绍： Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.