Abstract
BackgroundWorldwide, hepatobiliary cancers are frequent diseases and often accompanied by a poor prognosis. These cancers, with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CHC) being the most frequent, are often associated with a considerable amount of psychological burden such as anxiety, depressiveness, and reduced health-related quality of life (HRQOL) which may lead to psychiatric comorbidities. This systematic review gives an overview on psychological burden and on the effectiveness of psycho-oncological interventions for patients with HCC and CHC.MethodsThe databases PubMed, PubPsych, and PsycINFO were used and searched using the following combination of terms: (Neoplasm OR Cancer OR Tumor OR Carcinoma) AND (Psycho-Oncology OR Psychotherapy OR Psychiatr∗) AND (Liver OR Hepatic OR Hepatocellular OR Gallbladder OR Bile∗). Studies were eligible for inclusion if investigating patients affected with tumors of the liver (HCC/CHC) and using diagnostic instruments to assess mental health symptoms and research concerning specific psycho-oncological interventions. In total, 1027 studies were screened by one author with regard to title and abstracts. Afterward, the two authors of the paper discussed inclusion of possible articles.ResultsTwelve studies focusing on distress, anxiety, and depression symptoms as well as quality of life among patients with HCC/CHC and three studies on psycho-oncological interventions were included. Patients suffering from hepatobiliary cancers often experience considerable psychological burden. A quarter of patients suffer from depressive symptoms; anxiety is even more common among these patients with almost 40%. The HRQOL of those affected is reduced in almost all areas, suicide rates increased and the level of distress is considerably increased in one third of patients even in comparison to those with other kinds of cancer. By psycho-oncological intervention the prevalence of depressive symptoms and anxiety can be reduced, while the quality of life and also the survival rate of patients with hepatobiliary cancer can be increased.Discussion and ConclusionPsychological burden is high in patients with hepatobiliary cancers as reflected in high levels of depressiveness and anxiety as well as reduced quality of life. The use of psycho-oncological interventions can reduce psychological burden and increase quality of life compared to patients receiving standard support only.Systematic Review Registration(prospero), identifier (CRD42021243192).
Highlights
In Europe and North America cancer of the liver–with hepatocellular carcinoma (HCC) accounting for 75% and cholangiocarcinoma (CHC) for approximately 23% of all liver cancers (Mittal and El-Serag, 2013)–is a rather rare kind of cancer with an incidence of 5.1–11.6 per 100,000 population in men and 1.3–4.3 per 100,000 population in women (Kim et al, 2019; Sayiner et al, 2019)
To date, there is no clear knowledge about the impact of hepatobiliary cancers on mental health and the effect of psycho-oncological interventions in patients with hepatobiliary cancers
This is the first systematic review summarizing the psychological burden of patients with hepatobiliary cancers and the need for psycho-oncological interventions in this patient population
Summary
In Europe and North America cancer of the liver–with hepatocellular carcinoma (HCC) accounting for 75% and cholangiocarcinoma (CHC) for approximately 23% of all liver cancers (Mittal and El-Serag, 2013)–is a rather rare kind of cancer with an incidence of 5.1–11.6 per 100,000 population in men and 1.3–4.3 per 100,000 population in women (Kim et al, 2019; Sayiner et al, 2019). Hepatobiliary cancers are frequent diseases and often accompanied by a poor prognosis. These cancers, with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CHC) being the most frequent, are often associated with a considerable amount of psychological burden such as anxiety, depressiveness, and reduced health-related quality of life (HRQOL) which may lead to psychiatric comorbidities.
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