Quality of life as an outcome measure in surgical oncology

Background: There is a growing interest in assessing the impact of a disease and the effect of a treatment on a patient's life, expressed as health-related quality of Life (HRQoL). HRQoL assessment can provide essential outcome information for cancer surgery. Methods: The core of this review is derived from a literature search of the Medline database. Results: Three types of HRQoL instrument can be distinguished: generic, disease specific and symptom specific. There are criteria against which HRQoL instruments may be evaluated. The instrument chosen must be reliable, valid and sensitive to change. Conclusion: HRQoL measurement may be useful in identifying the optimal surgical procedure. It may also be of help in deciding whether surgery in patients with limited life expectancy should still be considered. No HRQoL instrument fits all the recommended conditions or is suitable in all clinical situations. Using the appropriate instrument is essential to arrive at valid and clinically meaningful outcome measures.