Systematic review and meta-analysis reveals symptom clusters negatively affect quality of life in gastrointestinal cancer patients, suggesting areas for clinical focus.
BACKGROUND: Gastrointestinal cancers present with complex symptom burdens that significantly impact treatment outcomes and patients' quality of life. Symptom clusters have been examined in various cancer types, yet a comprehensive synthesis of their patterns and impact in gastrointestinal cancer remains lacking. AIM: To summarize symptom clusters in gastrointestinal cancer patients, explore their longitudinal stability, and determine the relationship between relatively stable symptom clusters and quality of life. DESIGN: A systematic review and meta-analysis. DATA SOURCES: The included studies were sourced from PubMed, Embase, Cochrane Library, Web of Science, Medline, and the CNKI database, covering publications up to September 2024. REVIEW METHODS: Two reviewers independently screened and extracted data using prespecified criteria, in accordance with PRISMA 2020. The primary outcome was symptom clusters; the secondary outcome was their association with quality of life. Meta-analysis and visualizations were conducted using R 4.4.2. RESULTS: A total of 45 studies were included in this review. The common symptom clusters observed in gastrointestinal cancer patients were the pain-fatigue-sleep disturbance symptom cluster, the gastrointestinal symptom cluster I, and the psychological symptom cluster. Each of these clusters showed a moderate negative correlation with quality of life. Subgroup analyses identified cancer type, time point, study quality, and publication year as potential sources of heterogeneity. CONCLUSION: This review identifies three stable symptom clusters in gastrointestinal cancer, which show a moderate negative correlation with quality of life, highlighting the need for standardized assessments. IMPACT: Common symptom clusters have been identified in gastrointestinal cancer patients. These clusters show a moderate negative correlation with quality of life. Clinical staff can prioritize the management of these common symptom clusters, enabling integrated management of multiple symptoms to enhance efficiency, improve patient outcomes, and quality of life. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. TRIAL REGISTRATION: PROSPERO: CRD42024584049.
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