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Popovici D, Stanisav C, Sima LV, Negru A, Murg SI, Carabineanu A. Influence of Biomarkers on Mortality among Patients with Hepatic Metastasis of Colorectal Cancer Treated with FOLFOX/CAPOX and FOLFIRI/CAPIRI, Including Anti-EGFR and Anti-VEGF Therapies. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1003. [PMID: 38929620 PMCID: PMC11205545 DOI: 10.3390/medicina60061003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients.
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Affiliation(s)
- Dorel Popovici
- Department of Oncology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cristian Stanisav
- Departments of Radiology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Laurentiu V. Sima
- Department of Surgical Semiology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Alina Negru
- Department of Cardiology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Sergiu Ioan Murg
- Doctoral School of Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 1 Decembrie Square 10, 410073 Oradea, Romania
| | - Adrian Carabineanu
- Department of Surgical Semiology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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García-González D, Romero-Elías M, Álvarez-Bustos A, Rosado-García S, Sánchez-López AJ, Cantos B, Maximiano C, Méndez M, Méndez-Otero M, Cebolla H, García-Foncillas J, Ruiz-Casado A. Cancer-Related Fatigue and Circulating Biomarkers in Breast Cancer Survivors. Biol Res Nurs 2024; 26:270-278. [PMID: 37947791 DOI: 10.1177/10998004231215777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is the most common and disruptive symptom experienced by cancer survivors and because of its frequency and severity is especially worrisome in breast cancer survivors (BCS). Despite a great deal of research, the mechanisms underlying CRF have not been determined. The present study aims to describe associations between CRF in BCS and different blood biomarkers. METHODS A descriptive and cross-sectional study was conducted. A set of biomarkers assessing inflammation were measured in BCS: C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor (TNF); HPA axis dysfunction (cortisol), autonomic dysfunction (noradrenaline); oxidative stress (8-OH deoxyguanosine); insulin resistance markers (insulin, IGF-I, IGFBP3) and sexual hormones (estrogens, progesterone, testosterone). RESULTS NLR (p = .00) and cortisol (p = .02) were positive and negatively associated with CRF, respectively. The rest of the blood markers were not associated with CRF. CONCLUSION Our results increase the evidence on pathophysiological mechanisms driving CRF in BCS. However, longitudinal studies are needed to explore the role of these factors as potential causal mechanisms.
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Affiliation(s)
| | - María Romero-Elías
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Alejandro Álvarez-Bustos
- Biomedical Research Center Network for Frailty and Healthy Ageing (CIBERFES), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Rosado-García
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Madrid, Spain
| | | | - Blanca Cantos
- Department of Medical Oncology, IDIPHISA, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Constanza Maximiano
- Department of Medical Oncology, IDIPHISA, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Miriam Méndez
- Department of Medical Oncology, IDIPHISA, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Marta Méndez-Otero
- Department of Medical Oncology, IDIPHISA, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Jesús García-Foncillas
- School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Translational Oncology Division, Oncohealth Institute, IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
- Department of Medical Oncology, UAM, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ana Ruiz-Casado
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
- Department of Medical Oncology, IDIPHISA, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Tie H, Shi L, Wang L, Hao X, Fang H, Li L. Symptom clusters and characteristics of cervical cancer patients receiving concurrent chemoradiotherapy: A cross-sectional study. Heliyon 2023; 9:e22407. [PMID: 38107307 PMCID: PMC10724552 DOI: 10.1016/j.heliyon.2023.e22407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/19/2023] Open
Abstract
Background Cervical cancer patients have a high symptom burden during concurrent chemoradiotherapy (CCRT) and urgently need precise symptom management strategies. Nonetheless, the symptom profile and influencing factors are unclear. Methods A total of 234 patients with cervical cancer who underwent CCRT in a tertiary care hospital clinical oncology center in Guangxi Zhuang Autonomous Region from March 2022 to March 2023 were included in the study. The general information questionnaire, M.D. Anderson symptom inventory, Fatigue Scale-14, Pittsburgh Sleep Quality Index, and grip strength test were used for the investigation. Symptom clusters were extracted by exploratory factor analysis, and latent profile analysis was performed using Mplus 8.0 software. Multinomial logistic regression was used to explore the factors influencing the potential categories of symptom clusters. Results Exploratory factor analysis extracted four symptom clusters: a fatigue-related symptom cluster, a gastrointestinal-related symptom cluster, a mood-related symptom cluster, and a physical-related symptom cluster, of which the fatigue-related symptom cluster was more severe and was divided into three potential categories: low fatigue-good muscle fitness type (25.63%), general fatigue-moderate muscle fitness type (68.37%) and high fatigue-low muscle fitness type (6%). Multinomial logistic regression analysis showed that hemoglobin levels, tumor stage, absence of complications, and unemployment were factors influencing the fatigue-related symptom cluster in patients undergoing CCRT for cervical cancer. Conclusions Cervical cancer patients experience multiple symptom clusters during CCRT. Different characteristics appeared in different clusters. Among them, fatigue-related symptom clusters were more severe and heterogeneous. In clinical practice, we should pay attention to and use high symptom feature predictors, focusing on the core symptoms that play a dominant role, achieving early identification and management, and reducing patients' symptom burden.
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Affiliation(s)
- Hao Tie
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- School of Nursing, Guangxi University of Chinese Medicine, Nanning, China
| | - Limei Shi
- Oncology Center Radiotherapy Ward 2, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Li Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Xinyu Hao
- School of Nursing, Guangxi University of Chinese Medicine, Nanning, China
| | - Hongyan Fang
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lirong Li
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Luo J, Liu R, Luo Y, Fang Q, Liu S, Yang Z, Miao J, Zhang L. The high burden of symptoms associated with cognitive impairment in lung cancer patients: A latent class analysis. Asia Pac J Oncol Nurs 2023; 10:100200. [PMID: 36890861 PMCID: PMC9988398 DOI: 10.1016/j.apjon.2023.100200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Objective To explore the association between the pain-fatigue-sleep disturbance-depression symptom cluster (SC) and cancer-related cognitive impairment (CRCI) in patients having lung cancer and to identify other factors influencing CRCI. Methods A cross-sectional study was conducted to investigate 378 patients having lung cancer in China from October 2021 to July 2022. The perceived cognitive impairment scale and the general anxiety disorder-7 were used to assess patients' cognitive impairment and anxiety, respectively. The pain-fatigue-sleep disturbance-depression SC was assessed with the brief fatigue inventory, the brief pain inventory, the Patient Health Questionnaire-9, and the Athens Insomnia Scale. Latent class analysis by Mplus.7.4 was used to identify latent classes of the SC. We adjusted for covariates in the multivariable logistic regression model to examine the relationship between the pain-fatigue-sleep disturbance-depression SC and CRCI. Results Among patients having lung cancer, two SC classes were identified: high and low symptom burden groups. In the crude model, compared to the low symptom burden group, the high symptom group had greater odds of developing CRCI (odds ratio: 10.065, 95% confidence interval: 4.138-24.478). After adjusting for covariates, in model 1, the high symptom group still had greater odds of developing CRCI (odds ratio: 5.531, 95% confidence interval: 2.133-14.336). Additionally, a diagnosis of over 6 months, anxiety, leisure activity, and a high platelet-to-lymphocyte ratio were found to be influencing factors of CRCI (all P < 0.05). Conclusions Our study revealed that a high symptom burden is a significant risk factor for CRCI, which may provide a new perspective for managing CRCI in lung patients having cancer.
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Affiliation(s)
- Jiahui Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ruiqi Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Qinghong Fang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Suting Liu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
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Xu R, Gu Q, Xiao S, Zhao P, Ding Z. Patient-reported gastrointestinal symptoms following surgery for gastric cancer and the relative risk factors. Front Oncol 2022; 12:951485. [PMID: 36185286 PMCID: PMC9516295 DOI: 10.3389/fonc.2022.951485] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/23/2022] [Indexed: 12/09/2022] Open
Abstract
PurposeThe study aims to assess the incidence of short-term patient-reported postoperative gastrointestinal symptoms (PGISs) after gastric cancer surgery and explore the relative risk factors for the symptoms.MethodsPatients with radical gastrectomy were included for this retrospective and observational study. Symptoms extracted from the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI) were collected in postdischarge week (PDW) 1 and postoperative month (POM) 1. The distributing states of symptoms were analyzed in PDW1 and POM1. Logistic regression models were used to identify risk factors for PGISs.ResultsAmong 356 patients with complete interviews, 156 (43.8%) patients reported abdominal distention in PDW1, which was significantly higher than patients in POM1 [103 (28.9%), p < 0.001]. Pain (15.2% vs. 9.8%), dysphagia (5.6% vs. 7.0%), diarrhea (3.7% vs. 3.4%), and vomiting (2.5% vs. 2.8%) had no significant differences between PDW1 and POM1. Logistic models found that risk factors for PGISs were total gastrectomy [odds ratio (OR): 1.948; 95% CI: 1.097–3.459; p = 0.023] and disturbed sleep (OR: 3.116; 95% CI: 1.831–5.303; p < 0.001) in PDW1 and female gender (OR: 1.726; 95% CI: 1.071–2.782; p = 0.025), total gastrectomy (OR: 1.729; 95% CI: 1.055–2.834; p = 0.030), and disturbed sleep (OR: 3.533; 95% CI: 1.757–7.106; p < 0.001) in POM1.ConclusionsThe main symptom after gastric cancer surgery was abdominal distention. The relative risk factors for gastrointestinal symptoms after gastric cancer surgery were total gastrectomy and disturbed sleep. Timely symptom intervention may improve the quality of life of postgastrectomy patients.
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