Health state utility values in esophageal cancer: a systematic review and meta-analysis
Date
2025
Authors
Petric, J.
Kollias, V.
Hines, S.
Ahmed, M.
Navidi, M.
Bright, T.
Karnon, J.
Watson, D.I.
Bulamu, N.
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Journal article
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Annals of Esophagus, 2025; 8:16-1-16-15
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Josipa Petric, Victoria Kollias, Sonia Hines, Muktar Ahmed, Maziar Navidi, Tim Bright, Jonathan Karnon, David I. Watson, Norma Bulamu
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Abstract
Background: Patients receiving treatment for esophageal cancer often experience an array of symptoms affecting their health status, along with physical, psychological and social functioning, which impact quality of life. Previous systematic reviews of quality of life for esophageal cancer have been limited by the low quality of published studies, and this limits the provision of utility inputs for cost-utility analysis of esophageal cancer treatments. The aim of this systematic review was to reappraise the literature and summarize utility values for different health states associated with esophageal cancer care and treatment, specifically to inform inputs for future cost-utility analysis. Methods: The following databases were searched from database inception until September 2023 for articles written in English: MEDLINE (Ovid), Embase (OVID), Scopus, Web of Science Core Collections, Cochrane Register of Controlled Trials, CINAHL (EBSCOhost) and ProQuest. Empirical studies reporting utility values elicited directly or indirectly were included. The quality of articles was assessed using a combination of tools and mean utility values for studies applying the same utility elicitation methods and health state (disease stage, treatment or treatment timepoint) were pooled using random-effects models. Results: A total of 5,929 records were identified and 13 studies that clearly described health-related quality of life outcomes and met the criteria of adequate study quality were identified for analysis. Most studies were conducted in China (n=3), the UK (n=2), the Netherlands (n=2) and Australia (n=2). Utilities were most commonly elicited using EQ-5D-3L (n=9, 69.2%) and EQ-5D-5L (n=3, 23.1%). Six studies applying EQ-5D-3L were included in the meta-analysis and determination of outcomes vs. esophageal cancer stage—stage I: 0.66 [95% confidence interval (CI): 0.56–0.75, I²=83%], stages II/III: 0.84 (95% CI: 0.81–0.87, I²=48%), and stage IV: 0.67 (95% CI: 0.57–0.78, I²=85%). Conclusions: The EQ-5D is the most prevalent utility-based patient-reported outcome measure applied in esophageal cancer. Utility estimates using EQ-5D-3L at diagnosis for the different stages of esophageal cancer could be determined. However, due to heterogeneity in health states and studies, robust utility estimates for cost-utility analyses remain challenging. Future larger studies would facilitate more accurate estimates.
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© 2025 AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non- commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.