Ontology type: schema:ScholarlyArticle
2018-12-12
AUTHORSMyrte K. Neijenhuis, Titus F. M. Wijnands, Wietske Kievit, Maxime Ronot, Tom J. G. Gevers, Joost P. H. Drenth
ABSTRACTOBJECTIVE: To assess whether quantitative assessment of symptom reduction is a better outcome parameter than cyst volume reduction for treatment success in patients treated by aspiration sclerotherapy. METHODS: We included patients with symptomatic, large (> 5 cm), hepatic cysts from a randomized controlled trial (NCT02048319). At baseline and 6 months after treatment, symptoms were assessed with the polycystic liver disease questionnaire (PLD-Q) and we measured cyst volume using ultrasonography. Patient-reported change in health was assessed on a 5-point Likert scale (much worse to much better) after 6 months. We tested whether PLD-Q scores and cyst volumes changed after aspiration sclerotherapy (responsiveness). Changes in PLD-Q scores and cyst volume were compared with change in health as a measure of treatment success (discriminative ability). As secondary analysis, we compared baseline characteristics between responders (improved) and non-responders (not improved). RESULTS: We included 32 patients. Six months after treatment, 23 patients (72%) improved. Both PLD-Q score and cyst volume significantly decreased (median 38 to 18 points, p < 0.001, and 479 to 68 mL, p < 0.001). Larger improvement in PLD-Q score was associated with a positive change in health (p = 0.001), while larger proportional reduction in cyst volume was not significantly associated with health improvement after treatment (p = 0.136). Responders had larger baseline cyst volumes compared to non-responders (median 624 mL [IQR 343-1023] vs. 322 mL [IQR 157-423] p = 0.008). CONCLUSION: Cyst diameter reduction does not reflect treatment success in aspiration sclerotherapy from patients' perspective, while symptoms measured with the PLD-Q can be used as a reliable outcome measure. KEY POINTS: • Cyst diameter reduction poorly reflects treatment success in aspiration sclerotherapy. • Symptoms measured by the polycystic liver disease questionnaire (PLD-Q) is a better outcome measure than cyst volume reduction for treatment success after aspiration sclerotherapy. • Particularly patients with larger cysts (≥ 529 mL) benefit from aspiration sclerotherapy. More... »
PAGES1-7
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DOIhttp://dx.doi.org/10.1007/s00330-018-5851-y
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/30542749
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"description": "OBJECTIVE: To assess whether quantitative assessment of symptom reduction is a better outcome parameter than cyst volume reduction for treatment success in patients treated by aspiration sclerotherapy.\nMETHODS: We included patients with symptomatic, large (>\u20095\u00a0cm), hepatic cysts from a randomized controlled trial (NCT02048319). At baseline and 6\u00a0months after treatment, symptoms were assessed with the polycystic liver disease questionnaire (PLD-Q) and we measured cyst volume using ultrasonography. Patient-reported change in health was assessed on a 5-point Likert scale (much worse to much better) after 6\u00a0months. We tested whether PLD-Q scores and cyst volumes changed after aspiration sclerotherapy (responsiveness). Changes in PLD-Q scores and cyst volume were compared with change in health as a measure of treatment success (discriminative ability). As secondary analysis, we compared baseline characteristics between responders (improved) and non-responders (not improved).\nRESULTS: We included 32 patients. Six months after treatment, 23 patients (72%) improved. Both PLD-Q score and cyst volume significantly decreased (median 38 to 18 points, p\u2009<\u20090.001, and 479 to 68\u00a0mL, p\u2009<\u20090.001). Larger improvement in PLD-Q score was associated with a positive change in health (p\u2009=\u20090.001), while larger proportional reduction in cyst volume was not significantly associated with health improvement after treatment (p\u2009=\u20090.136). Responders had larger baseline cyst volumes compared to non-responders (median 624\u00a0mL [IQR 343-1023] vs. 322\u00a0mL [IQR 157-423] p\u2009=\u20090.008).\nCONCLUSION: Cyst diameter reduction does not reflect treatment success in aspiration sclerotherapy from patients' perspective, while symptoms measured with the PLD-Q can be used as a reliable outcome measure.\nKEY POINTS: \u2022 Cyst diameter reduction poorly reflects treatment success in aspiration sclerotherapy. \u2022 Symptoms measured by the polycystic liver disease questionnaire (PLD-Q) is a better outcome measure than cyst volume reduction for treatment success after aspiration sclerotherapy. \u2022 Particularly patients with larger cysts (\u2265\u2009529\u00a0mL) benefit from aspiration sclerotherapy.",
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