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Advanced hepatocellular carcinoma and palliative care: a scoping review
  1. Tian Tian1,
  2. Ju Guo2,
  3. Ju-Lan Hu3,
  4. Yue Hu4,
  5. Ping Guo1 and
  6. Xiao-Yun Yu4
  1. 1 School of Nursing, Hunan University of Tradtional Chinese Medicine, Changsha, Hunan, China
  2. 2 Graduate of School, GuangXi University of Traditional Chinese Medicine, Nanning, Guangxi, China
  3. 3 Department of Rehabilitation, Affiliated Hospital of Jinggangshan University, Ji’An, Jiangxi, China
  4. 4 Department of Nursing, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
  1. Correspondence to Professor Xiao-Yun Yu, Department of Nursing, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing 400011, China; yxy8383{at}


Background Patients with advanced hepatocellular carcinoma (HCC) have specific palliative care needs owing to the influence of the disease on abdominal pain, jaundice, bleeding, appetite, ascites, liver function and hepatic encephalopathy. This research would help develop care models and identify knowledge gaps in the field.

Aims To identify the palliative care needs and experiences of patients with advanced HCC.

Methods CINAHL, EMBASE and MEDLINE were used to search English literature from January 1998 to March 2022 for ‘Palliative care’ and ‘Hepatocellular cancer’ using precise inclusion and exclusion criteria.

Results The retrieves identified 2710 records, including 33 studies used in our research. Two additional studies were grey items. Among 35 studies, 13 studies were performed in Asia, 11 studies in North America, 8 studies in Europe and 3 studies in Australia. Quantitative investigations were mostly descriptive or observational. Eight studies were conducted on a national scale, while two were in specific regions. 20 studies were conducted by a single institution. 22 studies focused only on patients, 2 on family caregivers and 2 on healthcare professionals. 2 more studies concentrated on patients and family caregivers, while 6 concentrated on patients and healthcare professionals.

Conclusions This scoping study illustrates the complexity of advanced HCC treatment and challenges in modern healthcare systems. Formulating appropriate referral criteria, integrating and coordinating care, and assessing care contents are crucial. To enhance the treatment of patients with advanced HCC, it is important to understand the relationships between research and service design across teams, disciplines and care settings.

  • Liver
  • End of life care
  • Hospice care
  • Quality of life
  • Supportive care
  • Terminal care

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  • TT and JG are joint first authors.


  • Contributors TT and GJ performed the literature search and wrote the paper. HJL edited the paper. YXY proofread the paper and wrote the conclusion. HY and GP performed the literature search.

  • Funding This work was supported by the Chongqing Science and Health Joint TCM Technology Innovation and Application Development Project (grant no. 2020ZY3600).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.