Starkings R, Shilling V, Jenkins V, Fallowfield L
Sussex Health Outcomes Research and Education in Cancer (SHORE-C) Brighton and Sussex Medical School University of Sussex Brighton UK.
Skin Health Dis. 2021 May 7;1(3):e39. doi: 10.1002/ski2.39. eCollection 2021 Sep.
Cutaneous squamous cell carcinoma (cSCC) accounts for nearly a quarter of non-melanoma skin cancers. Studies reporting Quality of Life (QoL) in this group focus on early stage disease. A small proportion of cSCC patients have high-risk or advanced disease, with potentially significant QoL impacts, yet are largely overlooked.
This structured review appraises measures and published QoL outcomes in this group.
MATERIALS & METHODS: We conducted searches in MEDLINE, EMBASE, CINAHLplus and PsycInfo in June 2020 (updated in October) to identify publications specifically reporting QoL outcomes in this cohort. Returns were reviewed against a strict set of eligibility criteria.
We identified seven publications for inclusion; three relating to high-risk cSCC, three to metastatic disease and one to unresectable disease. Publications were appraised for quality using the Mixed Methods Appraisal Tool. Only one fulfilled more than two of the five quality criteria. Studies employed a range of patient reported outcome measures to assess QoL, both generic and disease specific.
All studies with multiple time-points reported stable or improving QoL, however extrapolation of these findings to the cSCC population is not warranted due to study limitations including mixed populations, incomplete data sets or single measurements. We set out to review the QoL literature for high-risk and advanced cSCC and found a small and disparate body of evidence. Studies varied significantly in terms of study population, design and quality. While the identified studies suggested stable or improving QoL, we question the choice of measures used and highlight the need for further work in this area.
While there are some published reports about quality of life for patients with early stage cutaneous squamous cell carcinoma, these impacts for the high-risk or advanced cohort are largely unexplored. We conducted a structured review of published measures and outcomes used in this cohort and found a demonstrable need for further, targeted, exploration of patient needs in this area.
皮肤鳞状细胞癌（cSCC）占非黑色素瘤皮肤癌的近四分之一。关于该群体生活质量（QoL）的研究主要集中在早期疾病。一小部分cSCC患者患有高危或晚期疾病，可能对生活质量产生重大影响，但在很大程度上被忽视了。
本结构化综述评估该群体的测量方法和已发表的生活质量结果。
我们于2020年6月（10月更新）在MEDLINE、EMBASE、CINAHLplus和PsycInfo中进行检索，以确定专门报告该队列生活质量结果的出版物。根据一套严格的纳入标准对检索结果进行审查。
我们确定了七篇纳入文献；三篇与高危cSCC相关，三篇与转移性疾病相关，一篇与不可切除疾病相关。使用混合方法评估工具对文献质量进行评估。只有一篇满足五项质量标准中的两项以上。研究采用了一系列患者报告的结局指标来评估生活质量，包括通用指标和疾病特异性指标。
所有具有多个时间点的研究均报告生活质量稳定或改善，然而，由于研究存在局限性，包括人群混杂、数据集不完整或单次测量等，这些研究结果不能外推至cSCC总体人群。我们着手回顾高危和晚期cSCC的生活质量文献，发现证据较少且分散。研究在研究人群、设计和质量方面差异很大。虽然已确定的研究表明生活质量稳定或改善，但我们对所使用的测量方法的选择提出质疑，并强调该领域需要进一步开展工作。
虽然有一些关于早期皮肤鳞状细胞癌患者生活质量的已发表报告，但高危或晚期患者群体的这些影响在很大程度上尚未得到探索。我们对该队列中已发表的测量方法和结果进行了结构化综述，发现显然需要进一步有针对性地探索该领域患者的需求。
