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Reis ASLDS, Furtado GE, Menuchi MRTP, Borges GF. The Impact of Exercise on Interleukin-6 to Counteract Immunosenescence: Methodological Quality and Overview of Systematic Reviews. Healthcare (Basel) 2024; 12:954. [PMID: 38786366 PMCID: PMC11121001 DOI: 10.3390/healthcare12100954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study evaluated the methodological quality of published systematic reviews on randomized and non-randomized clinical trials to synthesize evidence on the association between IL-6, immunosenescence, and aerobic and/or resistance exercise. METHOD The Preferred Reporting Items for Overviews of Systematic Reviews (PRIO-harms) guideline was used, with registration number CRD42022346142-PROSPERO. Relevant databases such as Cochrane Library, PubMed, Web of Science, Scopus, and Google Scholar were searched using English Medical Subject Headings terms. Inclusion criteria were systematic reviews analyzing aerobic exercise, resistance exercise, or a combination of both and assessing IL-6 as a biomarker of cellular immunosenescence in humans. The Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was employed. RESULTS Out of 742 identified articles, 18 were eligible, and 13 were selected for analysis. Sample sizes ranged from 249 to 1421 participants, mostly female, with ages ranging from 17 to 95 years. Aerobic exercise was the most studied type (46.15%), followed by combined exercise (38.46%) and resistance exercise (15.38%). Aerobic exercise showed a statistically significant reduction in IL-6, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels. Among the 13 reviews analyzed using AMSTAR-2, 8 were rated as critically low quality, and 5 were classified as low quality. CONCLUSION Aerobic exercise has anti-inflammatory properties and the potential to modulate IL-6, CRP, and TNF-α levels in immunosenescence. However, the limited methodological quality of the analyzed systematic reviews highlights the urgent need for robust, high-quality studies to improve access to information and facilitate evidence-based decision-making in healthcare.
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Affiliation(s)
- Anne Sulivan Lopes da Silva Reis
- Postgraduate Program in Physical Education, The State University of Santa Cruz (PPGEF/UESB/UESC), Ilhéus 45650-000, BA, Brazil; (A.S.L.d.S.R.); (M.R.T.P.M.)
| | - Guilherme Eustáquio Furtado
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços-S. Martinho do Bispo, 3045-093 Coimbra, Portugal;
- Research Centre for Natural Resources Environment and Society (CERNAS), Polytechnic Institute of Coimbra, Bencanta, 3045-601 Coimbra, Portugal
- Sport Physical Activity and Health Research & Inovation Center, 4960-320 Melgaço, Portugal
| | | | - Grasiely Faccin Borges
- Postgraduate Program in Physical Education, The State University of Santa Cruz (PPGEF/UESB/UESC), Ilhéus 45650-000, BA, Brazil; (A.S.L.d.S.R.); (M.R.T.P.M.)
- Center for Public Policies and Social Technologies, Federal University of Southern Bahia, Praça José Bastos, s/n, Centro, Itabuna 45600-923, BA, Brazil
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2
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Mészáros Crow E, López-Gigosos R, Mariscal-López E, Agredano-Sanchez M, García-Casares N, Mariscal A, Gutiérrez-Bedmar M. Psychosocial interventions reduce cortisol in breast cancer patients: systematic review and meta-analysis. Front Psychol 2023; 14:1148805. [PMID: 37441329 PMCID: PMC10333719 DOI: 10.3389/fpsyg.2023.1148805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/01/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Cancer initiation, progression and recurrence are intricate mechanisms that depend on various components: genetic, psychophysiological, or environmental. Exposure to chronic stress includes fear of recurrence that can affect biological processes that regulate immune and endocrine systems, increase cancer risk, and influence the survival rate. Previous studies show that psychological interventions might influence the level of cortisol that has been extensively used as a biomarker for measuring hypothalamic-pituitary-adrenal axis functioning and body's immunity response. This meta-analysis aimed to provide a quantitative scrutiny of the effect of certain types of psychosocial interventions on cortisol as a neuroendocrine biomarker in saliva or blood and might predict breast cancer (BC) progression. Methods A literature search was performed in the following databases: PubMed, The Cohrane Library, Scopus, WOS, PsychInfo, Google Scholar, Ovid Science Direct. After methodical selection of originally generated 2.021 studies, the search yielded eight articles that met inclusion criteria. All these studies explored effects of psychosocial interventions that measured cortisol in total of 366 participants with BC, stages 0-IV, in randomized control trial or quasi experimental study design setting. We applied random effects model to conduct meta-analyses on the parameters of salivary and plasma cortisol and used PRISMA Guidelines as validated methodology of investigation to report the results. Results Eight studies selected for meta-analysis have shown the reduction of cortisol level due to applied psychosocial intervention. The random effects model showed that interventions produced large effect sizes in reductions of cortisol in blood (Cohen's d = -1.82, 95% Confidence Interval (CI): -3.03, -0.60) and slightly less in saliva (d = -1.73, 95%CI: -2.68, -0.78) with an overall effect of d = -1.76 (95%CI: -2.46, -1.07). Conclusion Our study concluded that certain types of psychosocial interventions reduce cortisol (indicator of chronic stress) in patients with BC. Application of specific psychosocial support as adjuvant non-invasive therapy for affected females with BC at all phases of treatment could contribute to more cost-effective health care.
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Affiliation(s)
- Edith Mészáros Crow
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
| | - Rosa López-Gigosos
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain
| | - Eloisa Mariscal-López
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
| | - Marina Agredano-Sanchez
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
| | - Natalia García-Casares
- Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain
- Department of Medicine, School of Medicine, University of Málaga, Málaga, Spain
- Centro de Investigaciones Medico-Sanitarias (C.I.M.E.S), Málaga, Spain
| | - Alberto Mariscal
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain
| | - Mario Gutiérrez-Bedmar
- Department of Public Health and Psychiatry, School of Medicine, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain
- CIBERCV Cardiovascular Diseases, Carlos III Health Institute, Madrid, Spain
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Li L, Li J, Jia J, He H, Li M, Yan X, Yu Q, Guo H, Wang H, Lv Z, Sun H, Liao G, Cui J. Clonal evolution characteristics and reduced dimension prognostic model for non-metastatic metachronous bilateral breast cancer. Front Oncol 2022; 12:963884. [PMID: 36249030 PMCID: PMC9559188 DOI: 10.3389/fonc.2022.963884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHow to evaluate the prognosis and develop overall treatment strategies of metachronous bilateral breast cancer (MBBC) remains confused in clinical. Here, we investigated the correlation between clonal evolution and clinical characteristics of MBBC; we aim to establish a novel prognostic model in these patients.MethodsThe data from Surveillance, Epidemiology, and End Results (SEER) database and the First Hospital of Jilin University were analyzed for breast cancer–specific cumulative mortality (BCCM) by competing risk model. Meanwhile, whole-exome sequencing was applied for 10 lesions acquired at spatial–temporal distinct regions of five patients from our own hospital to reconstruct clonal evolutionary characteristics of MBBC. Then, dimensional-reduction (DR) cumulative incidence function (CIF) curves of MBBC features were established on different point in diagnostic interval time, to build a novel DR nomogram.ResultsSignificant heterogeneity in genome and clinical features of MBBC was widespread. The mutational diversity of contralateral BC (CBC) was significantly higher than that in primary BC (PBC), and the most effective prognostic MATH ratio was significantly correlated with interval time (R2 = 0.85, p< 0.05). In SEER cohort study (n = 13,304), the interval time was not only significantly affected the BCCM by multivariate analysis (p< 0.000) but determined the weight of clinical features (T/N stage, grade and ER status) on PBC and CBC in prognostic evaluation. Thus, clinical parameters after DR based on interval time were incorporated into the nomogram for prognostic predicting BCCM. Concordance index was 0.773 (95% CI, 0.769–0.776) in training cohort (n = 8,869), and 0.819 (95% CI, 0.813–0.826) in validation cohort (n = 4,435).ConclusionsBilateral heterogeneous characteristics and interval time were determinant prognostic factors of MBBC. The DR prognostic nomogram may help clinicians in prognostic evaluation and decision making.
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Affiliation(s)
- Lingyu Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jiaxuan Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jiwei Jia
- School of Mathematics, Jilin University, Changchun, China
- National Applied Mathematical Center (Jilin), Changchun, China
| | - Hua He
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Mingyang Li
- College of Electronic Science and Engineering, Jilin University, Changchun, China
| | - Xu Yan
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Qing Yu
- Department of Translational Medicine, Geneplus-Beijing, Beijing, China
| | - Hanfei Guo
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hong Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Zheng Lv
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Haishuang Sun
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Guidong Liao
- School of Mathematics, Jilin University, Changchun, China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Jiuwei Cui,
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Yao Y, Xu Y, Guo H, Han K, Dai Z. Effect of Integrated Psychobehavioral Care on Emotional-Behavioral Responses, Cognitive Changes in Outpatients with Schizophrenia Followed Up: Based on a Prospective Randomized Controlled Study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1862396. [PMID: 35756401 PMCID: PMC9225882 DOI: 10.1155/2022/1862396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 12/28/2022]
Abstract
Background In recent years, influenced by the continuous improvement and development of the medical service model and the increasing demands of modern people for the quality of clinical care, the clinical treatment of schizophrenic groups has also received widespread attention and importance from all sectors of society. Psychobehavioral care is administered to patients during active antipsychotic treatment, which can maximize the patient's cooperation with clinical work and thus play an auxiliary role in treatment. Aims To investigate the impact of emotional-behavioral responses, cognitive changes in outpatient follow-up of schizophrenic patients with integrated psychobehavioral care. Materials and Methods One hundred cases of schizophrenia patients with outpatient follow-up in our hospital from March 2017 to March 2019 were selected as prospective study subjects and divided into a comparison group and an observation group of 50 cases each according to a random number table. Among them, the comparison group implemented conventional psychobehavioral care, and the observation group implemented integrated psychobehavioral care. The differences in compliance behavior, negative emotions, cognitive behavioral changes, and pain scores before and after care of schizophrenia patients in the outpatient follow-up were compared between the two groups. Results After care, the compliance behavior, negative emotions, cognitive behavioral changes, and pain scores of schizophrenia patients in both groups with outpatient follow-up were significantly improved and significantly higher in the observation group than in the comparison group, and statistics showed that this difference was statistically significant (P < 0.05). Conclusion Integrated psychobehavioral care combined with conventional psychobehavioral care can effectively enhance the compliance behavior of outpatient follow-up schizophrenia patients, improve the negative emotions and pain of patients, and facilitate the active treatment of patients to improve their prognosis. It has some reference value for outpatient follow-up schizophrenia patient care.
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Affiliation(s)
- Yao Yao
- Department of Outpatient, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu Province, China
| | - Yali Xu
- The Sixth Stationed Outpatient Department, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu Province, China
| | - Hongyan Guo
- Department of Health Medicine, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu Province, China
| | - Kunxiu Han
- Department of Invasive Technology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu Province, China
| | - Zhuo Dai
- Department of Burn and Plastic Surgery, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu Province, China
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Costas-Muñiz R, Garduño-Ortega O, Hunter-Hernández M, Morales J, Castro-Figueroa EM, Gany F. Barriers to Psychosocial Services Use For Latina Versus Non-Latina White Breast Cancer Survivors. Am J Psychother 2021; 74:13-21. [PMID: 33028079 PMCID: PMC8573900 DOI: 10.1176/appi.psychotherapy.20190036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aims of this study were to compare barriers to use of psychosocial services by Latina versus non-Latina white women who had been diagnosed as having breast cancer and to examine associations between the barriers and use of psychosocial services. METHODS A sample of 265 Latina and non-Latina white women who had received treatment in a comprehensive cancer center in New York City completed a mailed questionnaire. The questionnaire measured quality of life, interest in receiving help for psychological distress, psychosocial services use, and barriers to use of psychosocial services. Bivariate and adjusted logistic regression models were used to analyze the data. RESULTS More than half of the sample reported preferring to return to their normal routines, felt they could take care of their emotional problems themselves, and preferred to seek support from their family or friends. Latinas were more likely to seek counseling from a spiritual leader, to report that there were no counselors who spoke their language and understood their values or background, and to report that mental health services were too expensive. CONCLUSIONS It is crucial to address the barriers that contribute to health disparities and discrepancies in patient access to and use of psychosocial health care. These findings highlight the need to educate providers about patients' psychosocial needs, provide patients with information about the benefits of psychosocial services, normalize mental health service use, diminish stigma surrounding use of these services, and provide culturally and linguistically sensitive services for Latina patients.
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Affiliation(s)
- Rosario Costas-Muñiz
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 485 Lexington Avenue, 2nd floor, New York, NY, USA 10017
- Weill Cornell Medica College
| | - Olga Garduño-Ortega
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 485 Lexington Avenue, 2nd floor, New York, NY, USA 10017
| | - Migda Hunter-Hernández
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 485 Lexington Avenue, 2nd floor, New York, NY, USA 10017
| | - Jennifer Morales
- School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Eida M. Castro-Figueroa
- School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
- Department of Psychiatry, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 485 Lexington Avenue, 2nd floor, New York, NY, USA 10017
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6
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Nayeri ND, Bakhshi F, Khosravi A, Najafi Z. The Effect of Complementary and Alternative Medicines on Quality of Life in Patients with Breast Cancer: A Systematic Review. Indian J Palliat Care 2020; 26:95-104. [PMID: 32132792 PMCID: PMC7017686 DOI: 10.4103/ijpc.ijpc_183_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/02/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Breast cancer disease and its classic treatment lead to decrease in patients' quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer. Methods: English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants' characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques. Results: During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05). Conclusion: The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.
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Affiliation(s)
- Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bakhshi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Afifeh Khosravi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Najafi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
OBJECTIVE To determine whether psychological intervention (PI) changes the levels of immune indicators in cancer patients. METHODS We conducted a systematic search published up to July 2018, followed by a manual search. Randomized controlled trials were included. Two reviewers independently screened and extracted data, which were analyzed using Review manager 5.3. RESULTS Twenty-nine studies were included including four kinds of PI. Only stress management didn't result in immune changes; only cognitive behavior therapy affect NK cell activity. PI did not change immune indicators on cancer patients who completed therapy. Compared to patients not receiving PI, those received PI had significantly higher NK cell count and activity in whole blood; and serum levels of IL-2, IL-4, IFN-γ, lgA, and lgG. However, the differences in the serum levels of IL-6, IL-10, TNF-α, and IgM were not significant (P > .05), and the changes recorded for the CD3, CD4, and CD8 cell count, and CD4/CD8 ratios were inconsistent. CONCLUSIONS Although there are considerable evidences of PI's immune effect, but its magnitude was moderate. Therefore, it may be premature to conclude whether PI affects immunity of cancer patients. Further research is warranted, with special focus on the PI types and treatment methods.
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Affiliation(s)
- Ping Zhang
- Children's Hospital of Chongqing Medical University, Chongqing
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei
- China International Science and Technology Cooperation base of China Development and Critical Disorders, Chongqing Key Laboratory of Paediatric
- Ministry of Education Key Laboratory of Child Development and Disorder, Chongqing, China
| | - Lin Mo
- Children's Hospital of Chongqing Medical University, Chongqing
| | - Xia Li
- Children's Hospital of Chongqing Medical University, Chongqing
- China International Science and Technology Cooperation base of China Development and Critical Disorders, Chongqing Key Laboratory of Paediatric
- Ministry of Education Key Laboratory of Child Development and Disorder, Chongqing, China
| | - Qiyao Wang
- Children's Hospital of Chongqing Medical University, Chongqing
- China International Science and Technology Cooperation base of China Development and Critical Disorders, Chongqing Key Laboratory of Paediatric
- Ministry of Education Key Laboratory of Child Development and Disorder, Chongqing, China
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8
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Zhai Z, Zhang F, Zheng Y, Zhou L, Tian T, Lin S, Deng Y, Xu P, Hao Q, Li N, Yang P, Li H, Dai Z. Effects of marital status on breast cancer survival by age, race, and hormone receptor status: A population-based Study. Cancer Med 2019; 8:4906-4917. [PMID: 31267686 PMCID: PMC6712463 DOI: 10.1002/cam4.2352] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/21/2019] [Accepted: 06/02/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction It remains unclear whether marital status could affect the breast cancer‐caused special survival (BCSS) of patients with breast cancer. Therefore, we sought to explore the influence of demographic and pathological factors on prognosis of patients with breast cancer. Materials and methods We selected patients meeting the eligibility criteria from the Surveillance, Epidemiology, and End Results (SEER) cancer registry program. We assessed the effect of marital status on overall survival (OS) and BCSS using Kaplan‐Meier curve and multivariate Cox proportional hazards regression. Results Compared with divorced/separated/widowed (DSW) patients, the married (AHR 0.7483, 95% CI: 0.729‐0.7682, P < 0.001) and single patients had better BCSS (AHR 0.9096, 95% CI: 0.8796‐0.9406, P < 0.001). Married patients kept better prognosis among all age subgroups, while the better BCSS of single patients occurred only in groups older than 35 years. As for race and hormone receptor status (HRs), the better BCSS of single patients was only observed in white race (AHR 0.881, 95% CI: 0.8457‐0.9177, P < 0.001) and patients with ER+/PR + status (AHR 0.8844, 95% CI: 0.8393‐0.932, P < 0.001). Conclusion Our findings demonstrated that married and single patients with breast cancer had better prognosis than their DSW counterparts. Age, race, and HRs could affect the correlation between marital status and BCSS.
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Affiliation(s)
- Zhen Zhai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fang Zhang
- The Second Department of Oncology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefacture, Enshi, China
| | - Yi Zheng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Linghui Zhou
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tian Tian
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuai Lin
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yujiao Deng
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Peng Xu
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Hao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Na Li
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Pengtao Yang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hongtao Li
- Department of Breast Head and Neck surgery, The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Tumor Hospital), Urumqi, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Wu W, Fang D, Shi D, Bian X, Li L. Effects of marital status on survival of hepatocellular carcinoma by race/ethnicity and gender. Cancer Manag Res 2018; 10:23-32. [PMID: 29379317 PMCID: PMC5757210 DOI: 10.2147/cmar.s142019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose It is well demonstrated that being married is associated with a better prognosis in multiple types of cancer. However, whether the protective effect of marital status varied across race/ethnicity and gender in patients with hepatocellular carcinoma remains unclear. Therefore, we aimed to evaluate the roles of race/ethnicity and gender in this relationship. Patients and methods We identified eligible patients from Surveillance, Epidemiology and End Results (SEER) database during 2004–2012. Overall and cancer-specific survival differences across marital status were compared by Kaplan–Meier curves. We also estimated crude hazard ratios (CHRs) and adjusted hazard ratios (AHRs) with 95% confidence intervals (CIs) for marital status associated with survival by race/ethnicity and gender in Cox proportional hazard models. Results A total of 12,168 eligible patients diagnosed with hepatocellular carcinoma were included. We observed that married status was an independent protective prognostic factor for overall and cancer-specific survival. In stratified analyses by race/ethnicity, the AHR of overall mortality (unmarried vs married) was highest for Hispanic (AHR =1.25, 95% CI, 1.13–1.39; P<0.001) and lowest for Asian or Pacific Islander (AHR =1.13; 95% CI, 1.00–1.28; P=0.042). Stratified by gender, the AHR was higher in males (AHR =1.27; 95% CI, 1.20–1.33; P<0.001). Conclusion: We demonstrated that married patients obtained better survival advantages. Race/ethnicity and gender could influence the magnitude of associations between marital status and risk of mortality.
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Affiliation(s)
- Wenrui Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
| | - Daiqiong Fang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
| | - Ding Shi
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
| | - Xiaoyuan Bian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
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10
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Zhang J, Gan L, Wu Z, Yan S, Liu X, Guo W. The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study. Oncotarget 2017; 8:22385-22405. [PMID: 26894860 PMCID: PMC5410231 DOI: 10.18632/oncotarget.7399] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background & Aims Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. Methods We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Results Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. Conclusions These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment.
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Affiliation(s)
- Jieyun Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Lu Gan
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Zhenhua Wu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Shican Yan
- Department of Surgery, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xiyu Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Weijian Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
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11
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Effects of Qigong on symptom management in cancer patients: A systematic review. Complement Ther Clin Pract 2017; 29:111-121. [PMID: 29122248 DOI: 10.1016/j.ctcp.2017.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/05/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Qigong as a complementary and alternative therapy is often used by cancer patients for symptom management. The aim of this systematic review is to critically evaluate the effectiveness of Qigong on symptom management among cancer patients. METHODS A systematic search was conducted in the following databases from their inception through May 2016: Cochrane Library, PubMed/MEDLINE, CINAHL, PsycINFO, PEDRO. All controlled clinical trials of Qigong among cancer patients were included. The strength of the evidence was evaluated for all included studies using the Oxford Centre for Evidence-based Medicine Levels of Evidence. The risk of bias was assessed using the Cochrane Collaboration's Tool for Assessing Risk of Bias. RESULTS Twenty-two studies including fifteen randomized controlled trials and eight controlled clinical trials examined the efficacy of Qigong in symptom management among patients with various cancers. Results of these studies indicated that symptoms in the Qigong group were significantly improved or there was an observed positive trend from pre-to post-interventions scores for physical symptoms and psychological symptoms. CONCLUSION The effectiveness of Qigong as a health practice adopted by cancer patients to manage their symptoms during their cancer journey is not proven, but there are promising results that need further verification in future research.
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12
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Tan JT, Yang Y, Mao NQ, Liu DS, Huang DM, Pan H, Xie T, Pan Q, Yang L, Zhong JH, Zuo CT. Effect of neoadjuvant chemoradiotherapy on perioperative immune function of patients with locally advanced esophageal cancer. Dis Esophagus 2017; 30:1-8. [PMID: 27766708 DOI: 10.1111/dote.12486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study aims to evaluate the effect of neoadjuvant chemoradiotherapy (NCRT) on perioperative immune function during surgery to treat resectable locally advanced esophageal cancer. Records were retrospectively analyzed for 220 patients with locally advanced esophageal cancer, of whom 112 received surgery alone and 98 received neoadjuvant NCRT plus surgery. The two groups were compared in terms of proportions of CD3+, CD4+, CD8+, and natural kill (NK) cells, as well as the ratio of CD4+ to CD8+ cells. These measurements were made using flow cytometry on preoperative day 1 and on postoperative days 1 and 7. Subgroup analysis were performed in terms of degrees of pathological response of NCRT. When the entire NCRT and no-NCRT (surgery alone) cohorts were compared, no significant differences in propocrtions of CD3+, CD4+, CD8+, or NK cells or in the CD4+/CD8+ ratio occurred at any of the three time points. Similar results were obtained using the subgroup of NCRT patients who were NCRT-sensitive, but the subgroup of NCRT-insensitive patients showed significantly lower CD4+ and NK proportions and lower CD4+/CD8+ ratio than the no-NCRT group. Our findings suggest that NCRT does not affect perioperative immune function in patients who are NCRT-sensitive, but it does significantly reduce such function in patients who are NCRT-insensitive.
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Affiliation(s)
- Jun-Tao Tan
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Yang Yang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Nai-Qun Mao
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - De-Sen Liu
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Ding-Ming Huang
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Hong Pan
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Tong Xie
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Qi Pan
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Li Yang
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Jian-Hong Zhong
- Department of Surgical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Chuan-Tian Zuo
- Department of Thoracic Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
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13
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Tao WW, Jiang H, Tao XM, Jiang P, Sha LY, Sun XC. Effects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis. J Pain Symptom Manage 2016; 51:728-747. [PMID: 26880252 DOI: 10.1016/j.jpainsymman.2015.11.027] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
CONTEXT Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy (TCM-FEMT) reports controversial results. OBJECTIVES The primary objective of this meta-analysis was to evaluate the effect of acupuncture, Tuina, Tai Chi, Qigong, and TCM-FEMT on various symptoms and quality of life (QOL) in patients with cancer; risk of bias for the selected trials also was assessed. METHODS Studies were identified by searching electronic databases (MEDLINE via both PubMed and Ovid, Cochrane Central, China National Knowledge Infrastructure, Chinese Scientific Journal Database, China Biology Medicine, and Wanfang Database). All randomized controlled trials (RCTs) using acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT published before October 2, 2014, were selected, regardless of whether the article was published in Chinese or English. RESULTS We identified 67 RCTs (5465 patients) that met our inclusion criteria to perform this meta-analysis. Analysis results showed that a significant combined effect was observed for QOL change in patients with terminal cancer in favor of acupuncture and Tuina (Cohen's d: 0.21-4.55, P < 0.05), whereas Tai Chi and Qigong had no effect on QOL of breast cancer survivors (P > 0.05). The meta-analysis also demonstrated that acupuncture produced small-to-large effects on adverse symptoms including pain, fatigue, sleep disturbance, and some gastrointestinal discomfort; however, no significant effect was found on the frequency of hot flashes (Cohen's d = -0.02; 95% CI = -1.49 to 1.45; P = 0.97; I(2) = 36%) and mood distress (P > 0.05). Tuina relieved gastrointestinal discomfort. TCM-FEMT lowered depression level. Tai Chi improved vital capacity of breast cancer patients. High risk of bias was present in 74.63% of the selected RCTs. Major sources of risk of bias were lack of blinding, allocation concealment, and incomplete outcome data. CONCLUSION Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.
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Affiliation(s)
- Wei-Wei Tao
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China.
| | - Hua Jiang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Xiao-Mei Tao
- Beijing Shijitan Hospital, Beijing, People's Republic of China
| | - Ping Jiang
- Graduate School, Dalian Medical University, Dalian, People's Republic of China.
| | - Li-Yan Sha
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China
| | - Xian-Ce Sun
- College of Public Health, Dalian Medical University, Dalian, People's Republic of China
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Guo L, Du Y, Wang J. Network analysis reveals a stress-affected common gene module among seven stress-related diseases/systems which provides potential targets for mechanism research. Sci Rep 2015; 5:12939. [PMID: 26245528 PMCID: PMC4526881 DOI: 10.1038/srep12939] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/30/2015] [Indexed: 12/19/2022] Open
Abstract
Chronic stress (CS) was reported to associate with many complex diseases and stress-related diseases show strong comorbidity; however, molecular analyses have not been performed to date to evaluate common stress-induced biological processes across these diseases. We utilized networks constructed by genes from seven genetic databases of stress-related diseases or systems to explore the common mechanisms. Genes were connected based on the interaction information of proteins they encode. A common sub-network constructed by 561 overlapping genes and 8863 overlapping edges among seven networks was identified and it provides a common gene module among seven stress-related diseases/systems. This module is significantly overlapped with network that constructed by genes from the CS gene database. 36 genes with high connectivity (hub genes) were identified from seven networks as potential key genes in those diseases/systems, 33 of hub genes were included in the common module. Genes in the common module were enriched in 190 interactive gene ontology (GO) functional clusters which provide potential disease mechanism. In conclusion, by analyzing gene networks we revealed a stress-affected common gene module among seven stress-related diseases/systems which provides insight into the process of stress induction of disease and suggests potential gene and pathway candidates for further research.
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Affiliation(s)
- Liyuan Guo
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yang Du
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jing Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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