Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands.
European Reference Network RARE-LIVER, Hamburg, Germany.
J Clin Gastroenterol. 2022 Oct 1;56(9):731-739. doi: 10.1097/MCG.0000000000001749. Epub 2022 Aug 19.
Polycystic liver disease (PLD) is a genetic disorder in which patients suffer from progressive development of multiple (>10) hepatic cysts. Most patients remain asymptomatic during the course of their disease. However, a minority of PLD patients suffer from symptoms caused by hepatomegaly leading to serious limitations in daily life. Untreated symptomatic PLD patients score significantly worse on health-related quality of life (HRQoL) compared to age and gender-matched populations. Currently, liver transplantation is the only curative treatment for PLD. The main goal of other available therapies is to strive for symptomatic relief and improvement of HRQoL by suppressing disease progression. In this review, we summarize the effect of PLD treatment on patient-reported outcome measures with a distinction between HRQoL and symptom severity. At present there is heterogeneity in application of questionnaires and no questionnaire is available that measures both HRQoL and PLD symptom severity. Therefore, we recommend the combination of a validated PLD-specific symptom severity questionnaire and a general HRQoL questionnaire to evaluate treatment success as a minimal core set. However, the specific choice of questionnaires depends on treatment choice and/or research question. These questionnaires may serve as a biomarker of treatment response, failure, and adverse events.
多囊性肝病(PLD)是一种遗传性疾病,患者会出现多个(>10)肝囊肿的进行性发展。大多数患者在疾病过程中无症状。然而,少数 PLD 患者会因肝肿大引起症状,导致日常生活严重受限。未经治疗的有症状 PLD 患者在健康相关生活质量(HRQoL)方面的评分明显低于年龄和性别匹配的人群。目前,肝移植是 PLD 的唯一根治性治疗方法。其他可用治疗方法的主要目标是通过抑制疾病进展来争取症状缓解和 HRQoL 的改善。在这篇综述中,我们总结了 PLD 治疗对患者报告的结果测量的影响,区分了 HRQoL 和症状严重程度。目前,应用问卷存在异质性,没有一种问卷可以同时测量 HRQoL 和 PLD 症状严重程度。因此,我们建议将经过验证的 PLD 特异性症状严重程度问卷和一般 HRQoL 问卷相结合,作为最小核心集来评估治疗效果。然而,问卷的具体选择取决于治疗选择和/或研究问题。这些问卷可以作为治疗反应、失败和不良事件的生物标志物。