A Delphi Study of Core Patient-Reported Outcomes for Advanced Renal Cell Carcinoma and Advanced Hepatocellular Carcinoma

Semin Oncol Nurs. 2023 Aug;39(4):151409. doi: 10.1016/j.soncn.2023.151409. Epub 2023 Apr 1.


Objectives: There is little research to help health care professionals understand what patient outcomes are considered a priority in advanced liver or kidney cancer. Knowing what is important to patients can help promote person-centered approaches to treatment and disease management. The aim of this study was to identify those patient-reported outcomes (PROs) that patients, carers, and health care professionals consider as "core" when providing care to those with advanced liver or kidney cancer.

Data sources: A three-round Delphi study was undertaken to ask experts by profession or experience to rank PROs identified from a previous literature review. Fifty-four experts, including people living with advanced liver or kidney cancer (44.4%), family members and caregivers (9.3%), and health care professionals (46.8%), reached consensus on 49 PROs including 12 new items (eg, palpitations, hopefulness, or social isolation). Items with the highest rate of consensus included quality of life, pain, mental health, and capacity to do daily activities.

Conclusion: People living with advanced liver or kidney cancer experience complex health care needs. Some important outcomes were not actually captured in practice in this population and were suggested as part of this study. There are discrepancies between the views of health care professionals, patients, and family in what is important, highlighting the need of using measures to facilitate communication.

Implications for nursing practice: Identification of priority PROs reported here will be key to facilitate more focused patient assessments. The actual use of measures in cancer nursing practice to allow monitoring of PROs must be tested for feasibility and usability.

Keywords: Advanced hepatocellular carcinoma; Advanced renal cell carcinoma; Cancer; Patient-reported outcomes; Person-centered care; Quality of life.

MeSH terms

  • Carcinoma, Hepatocellular*
  • Carcinoma, Renal Cell* / therapy
  • Delphi Technique
  • Humans
  • Kidney Neoplasms* / therapy
  • Liver Neoplasms* / therapy
  • Patient Reported Outcome Measures
  • Quality of Life