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Sobrero A, Dasari A, Aquino J, Lonardi S, Garcia-Carbonero R, Elez E, Yoshino T, Yao J, Garcia-Alfonso P, Kocsis J, Gracian AC, Sartore-Bianchi A, Satoh T, Randrian V, Tomasek J, Chong G, Price T, Yu Z, Geiger A, Chen L, Yang Z, Schelman WR, Kania M, Tabernero J, Eng C. Health-related quality of life associated with fruquintinib in patients with metastatic colorectal cancer: Results from the FRESCO-2 study. Eur J Cancer 2025; 218:115268. [PMID: 39952149 DOI: 10.1016/j.ejca.2025.115268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 01/24/2025] [Accepted: 01/28/2025] [Indexed: 02/17/2025]
Abstract
INTRODUCTION Maintaining or improving health-related quality of life (HRQoL) is as important as extending survival in metastatic colorectal cancer. We report an HRQoL analysis from FRESCO-2 (NCT04322539). METHODS Patients were randomized to fruquintinib +best supportive care (BSC; n = 461) or placebo +BSC (n = 230). Instruments of EORTC QLQ-C30 and 5-level EQ-5D, and ECOG performance status (PS) were assessed. Changes from baseline scores for QLQ-C30 and EQ-5D were evaluated and minimally important difference thresholds were used to define stable, improved, or deteriorated QoL. Time to deterioration (TTD) was assessed. RESULTS With fruquintinib versus placebo, baseline QLQ-C30 global health status (GHS) and EQ-5D visual analog scale (VAS) scores were 65.2 versus 64.6 and 67.0 versus 66.6, respectively. Least-squares mean changes from baseline fluctuated throughout treatment. At end of treatment (EOT), mean scores with fruquintinib versus placebo were 53.8 versus 52.3 (QLQ-C30 GHS) and 58.9 versus 58.5 (EQ-5D VAS). For QLQ-C30 GHS, 38.3 % versus 36.5 % of patients receiving fruquintinib versus placebo had stable or improved scores at EOT; median TTD was 2.1 versus 1.8 months (HR, 0.9; 95 % CI, 0.7-1.0). For EQ-5D VAS, 47.9 % versus 42.7 % had stable or improved scores at EOT; median TTD was 2.6 versus 1.9 months (HR, 0.8; 95 % CI, 0.6-0.9). Median TTD to ECOG PS ≥ 2 or death within 30+ /7 days after EOT was 6.6 versus 2.9 months with fruquintinib versus placebo (HR, 0.6; 95 % CI, 0.4-0.7). CONCLUSIONS Fruquintinib delayed TTD of ECOG PS and did not negatively impact HRQoL versus placebo.
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Affiliation(s)
- Alberto Sobrero
- Department of Medical Oncology, Azienda Ospedaliera San Martino, Genoa, Italy.
| | - Arvind Dasari
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeneth Aquino
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sara Lonardi
- Medical Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS Padua, Padua, Italy
| | - Rocio Garcia-Carbonero
- Oncology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria lmas12, Facultad de Medicina UCM, CIBERONC, Madrid, Spain
| | - Elena Elez
- Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Takayuki Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - James Yao
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pilar Garcia-Alfonso
- Medical Oncology Service, Hospital G. U. Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | - Judit Kocsis
- Department of Oncoradiology, Bács-Kiskun Megyei Oktatókórház, Kecskemét, Hungary
| | - Antonio Cubillo Gracian
- Medical Oncology, Hospital Universitario Madrid Sanchinarro Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - Andrea Sartore-Bianchi
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Taroh Satoh
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Violaine Randrian
- Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France
| | - Jiri Tomasek
- Department of Complex Oncology Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Geoff Chong
- Olivia Newton-John Cancer & Wellness Centre, Austin Hospital, Heidelberg, VIC, Australia
| | - Timothy Price
- The Queen Elizabeth Hospital and University of Adelaide, Adelaide, SA, Australia
| | - Ziji Yu
- Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USA
| | - Ashley Geiger
- Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USA
| | - Lucy Chen
- Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USA
| | - Zhao Yang
- HUTCHMED International Inc., Florham Park, NJ, USA
| | | | - Marek Kania
- HUTCHMED International Inc., Florham Park, NJ, USA
| | - Josep Tabernero
- Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Cathy Eng
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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Pennings AJ, Kimman ML, Renehan AG, Perez RO, Azevedo J, Fernandez L, Gidding-Slok AHM, Melenhorst J, Beets GL, Breukink SO. A patient reported outcome measure for rectal cancer patients eligible for organ preservation: Development and validation of a Watch-and-Wait module for the Assessment of Burden of disease in ColoRectal Cancer (ABCRC) tool. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2025; 51:109501. [PMID: 39615295 DOI: 10.1016/j.ejso.2024.109501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 10/30/2024] [Accepted: 11/23/2024] [Indexed: 02/10/2025]
Abstract
AIM The Assessment of Burden of ColoRectal Cancer (ABCRC)-tool is an integrated tool, developed in conjunction with colorectal cancer (CRC) patients, that measures the experienced burden of disease and lifestyle parameters and visualizes the results. To provide tailored follow-up care for watch-and-wait (WW) patients, in line with their specific needs and preferences, a WW module for the ABCRC-tool was developed. In this paper we describe the development and validation process of the WW module. METHODS This study followed a multistep approach. First, a three-round Delphi survey was conducted with both patients and healthcare professionals (HP). Participants were asked to score common RC outcomes that emerged from qualitative interviews with patients and a targeted literature review. Based on included items, appropriate questions were formulated. Reliability was tested by assessing test-retest reliability, defined by Intra Class Correlation. Construct validity was evaluated by hypothesis testing. RESULTS A total of 128 participants (75 patients and 53 HP) from four countries (UK, Brazil, Portugal and Netherlands) participated in the Delphi survey which included 41 items. After the consensus meeting seven outcomes and appropriate questions (including anxiety, fear of recurrence, fear of surgery, fear of stoma, fecal incontinence, urgency and happiness) were included in the WW module. Validity and reliability testing was completed by 50 Dutch WW patients. The ABCRC-WW module demonstrated sound construct validity and reliability. CONCLUSION This study demonstrates good psychometric properties of the ABCRC-WW tool. This tool has the potential to facilitate patient-clinician communication, enhance patients' understanding of their condition, and enable individualized care through direct feedback.
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Affiliation(s)
- A J Pennings
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
| | - M L Kimman
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A G Renehan
- Manchester Cancer Research Centre, National Institute of Health and Research Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK; Colorectal and Peritoneal Oncology Centre, The Christie National Health Service Foundation Trust, Manchester, UK
| | - R O Perez
- Department of Colorectal Surgery, Angelita and Joaquim Gama Institute, São Paolo, Brazil
| | - J Azevedo
- Colorectal Surgery, Digestive Department, Champalimaud Foundation, Lisbon, Portugal
| | - L Fernandez
- Colorectal Surgery, Digestive Department, Champalimaud Foundation, Lisbon, Portugal
| | - A H M Gidding-Slok
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - J Melenhorst
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
| | - G L Beets
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - S O Breukink
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
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Li MC, Chen WM, Shia BC, Wu SY. Metformin Against Herpes Zoster in Colon Cancer Patients with Type 2 Diabetes: A PSM Analysis. J Cancer 2025; 16:1054-1065. [PMID: 39895800 PMCID: PMC11786045 DOI: 10.7150/jca.98852] [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: 05/24/2024] [Accepted: 09/10/2024] [Indexed: 02/04/2025] Open
Abstract
Background: Herpes zoster is a significant complication in cancer patients, particularly those with compromised immune systems. Previous studies have established the incidence of herpes zoster in gastrointestinal cancer patients, but there is a lack of specific analysis on colorectal cancer patients and the potential preventive role of metformin. This study aims to fill this gap by evaluating metformin's protective effects against herpes zoster in colon cancer patients with type 2 diabetes mellitus (T2DM). Methods: The study cohort comprised 1,510 T2DM colon adenocarcinoma patients without distant metastasis who received standard treatments from Taiwan Cancer Registry Database. Propensity score matching (PSM) was employed to balance covariates between metformin users and nonusers. Herpes zoster infection risk was assessed using Cox regression models and incidence rate calculations. The dose-dependent effects of metformin were analyzed based on cumulative defined daily doses (cDDD). Results: Metformin use was associated with a significantly reduced risk of herpes zoster infection (adjusted hazard ratio [aHR].: 0.69, 95% confidence interval [CI].: 0.51 to 0.93). A dose-dependent relationship was observed, with progressively lower aHRs across cDDD quartiles (p for trend < 0.0001). After adjusting for competing mortality risks, the aHR remained significantly lower (aHR: 0.70, 95% CI: 0.51 to 0.65). Metformin users had lower incidence rates and incidence rate ratios (IRR) of herpes zoster infection compared to nonusers (IRR: 0.75, 95% CI: 0.56 to 0.97). Conclusions: We are the first to demonstrate a dose-dependent protective effect of metformin against herpes zoster in colorectal cancer patients. Our findings indicate that higher doses of metformin correlate with a greater reduction in the risk of herpes zoster.
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Affiliation(s)
- Ming-Chang Li
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Department of Colorectal Surgery, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Ben-Chang Shia
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Management, College of Management, Fo Guang University, Yilan, Taiwan
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Kim NY, Vishwanath D, Basappa S, Harish KK, Madegowda M, Rangappa KS, Basappa B, Ahn KS. Isoxazole based nucleosides induce autophagy through the production of ROS and the suppression of the β-catenin pathway in human colorectal carcinoma cells. Chem Biol Interact 2024; 404:111285. [PMID: 39442680 DOI: 10.1016/j.cbi.2024.111285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 10/17/2024] [Accepted: 10/20/2024] [Indexed: 10/25/2024]
Abstract
β-catenin is frequently implicated in signaling pathways that regulate autophagy, and the production of reactive oxygen species (ROS) has been linked to autophagy activation. Isoxazole-based nucleoside compounds have demonstrated anti-cancer properties. In this study, we report the identification of novel isoxazole-nucleosides as anti-tumor agents and their impact on autophagy in human colorectal carcinoma (CRC) cells. Among the ITP series, ITP-7 and ITP-9 (ITP-7/9) exhibited significant cytotoxicity compared to other compounds. Treatment with ITP-7/9 upregulated the expression of key autophagy-related proteins, including LC3 II, Atg7, and phosphorylated Beclin-1. Additionally, ITP-7/9 promoted the formation of LC3 II puncta and increased the number of AO-stained and MDC-stained cells, indicating enhanced autophagy. ROS levels were elevated following ITP-7/9 exposure, and treatment with N-acetyl l-cysteine (NAC), a ROS inhibitor, reduced the ITP-7/9-induced expression of LC3 II. Furthermore, ITP-7/9 inhibited β-catenin's role as a transcription factor, as observed in ICC assays. Moreover, cells with β-catenin gene deletion exhibited stronger autophagy when treated with ITP-7/9 compared to those treated with ITP-7/9 alone. These findings suggest that ITP-7/9 induces autophagy and promotes CRC cell death by downregulating β-catenin.
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Affiliation(s)
- Na Young Kim
- Department of Science in Korean Medicine, Kyung Hee University, 24 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Divakar Vishwanath
- Laboratory of Chemical Biology, Department of Studies in Organic Chemistry, University of Mysore, Manasagangotri, Mysuru, 570006, India
| | - Shreeja Basappa
- Department of Chemistry, BITS-Pilani, Hyderabad Campus, Jawahar Nagar, Medchal, 500078, India
| | - Keshav Kumar Harish
- Department of Studies in Physics, University of Mysore, Manasagangotri, Mysore, 570006, India
| | - Mahendra Madegowda
- Department of Studies in Physics, University of Mysore, Manasagangotri, Mysore, 570006, India
| | - Kanchugarakoppal S Rangappa
- Laboratory of Chemical Biology, Department of Studies in Organic Chemistry, University of Mysore, Manasagangotri, Mysuru, 570006, India
| | - Basappa Basappa
- Laboratory of Chemical Biology, Department of Studies in Organic Chemistry, University of Mysore, Manasagangotri, Mysuru, 570006, India.
| | - Kwang Seok Ahn
- Department of Science in Korean Medicine, Kyung Hee University, 24 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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Perinandika T, Rudiman R, Purnama A. The Effect of Vitamin D Supplementation on Quality of Life in Stage II-III Colorectal Cancer Patients Undergoing Adjuvant Chemotherapy: A Single-Blind, Randomized Controlled Trial. J Gastrointest Cancer 2024; 56:22. [PMID: 39557774 DOI: 10.1007/s12029-024-01142-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2024] [Indexed: 11/20/2024]
Abstract
INTRODUCTION Colorectal cancer is the third most common cancer with the second highest mortality worldwide in 2020. Adjuvant chemotherapy is given for stage II-III colorectal cancer. However, there are side effects that decrease the patient's quality of life. Several studies have found that vitamin D could reduce the side effects of chemotherapy, but studies at Hasan Sadikin Hospital have not been done. METHODS A study regarding the effect of vitamin D supplementation on the quality of life of stage II-III colorectal cancer patients undergoing adjuvant chemotherapy from May 2022 to April 2023 at Hasan Sadikin Hospital was conducted. A single-blinded, randomized controlled trial (RCT) with consecutive sampling was done at the digestive surgery outpatients. Data was taken from the medical record, history taking, and personal interviews. Quality of life was measured at the first, third, and sixth months after chemotherapy using the validated Indonesian version of the EORTC QLQ-C30 questionnaire. RESULTS A total of 34 patients received vitamin D and 34 others received placebo. Serum vitamin D levels significantly increased (p < 0.001) in the intervention arm, from a median of 21.34 (5.26-29.95) to 27.92 (13.58-40.49). Meanwhile, it decreased in the placebo arm, from a median of 22.78 (8.3-29.93) to 21.37 (7.45-31.26). The patient's quality of life improved significantly after receiving vitamin D, compared with the placebo group on the third (median of 75.0 vs 45.83) and sixth (median of 83.33 vs 33.33) months after chemotherapy. CONCLUSION Vitamin D consumption (10,000 IU/day) could improve the quality of life of colorectal cancer patients undergoing adjuvant chemotherapy.
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Affiliation(s)
- Tovan Perinandika
- Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, West Java, Bandung, Indonesia.
| | - Reno Rudiman
- Division of Digestive Surgery, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, West Java, Bandung, Indonesia
| | - Andriana Purnama
- Division of Digestive Surgery, Department of Surgery, Universitas Padjadjaran/Hasan Sadikin General Hospital, West Java, Bandung, Indonesia
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Mihăileanu F, Cismaru CA, Cordoș AA, Ciocan RA, Chiorescu S, Constantinescu I, Stancu B, Breazu C, Coman H, Berindan Neagoe I, Gherman CD. Specific Quality of Life Questionnaire Validation in Patients with Colorectal Cancer. Diagnostics (Basel) 2024; 14:2481. [PMID: 39594147 PMCID: PMC11592747 DOI: 10.3390/diagnostics14222481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/24/2024] [Accepted: 11/03/2024] [Indexed: 11/28/2024] Open
Abstract
(1) Background: The quality of life of cancer patients is not only important for their well-being, but it has great influence on the overall survival and response to therapy, considering the adherence to treatment and follow-up. (2) Methods: This research is a prospective study conducted over a period of 6 months involving patients admitted in the Department of Surgery II, Cluj County Emergency Clinical Hospital. The specific questionnaire designed by us for patients with colorectal cancer contains questions about the quality of life and symptoms such as weight loss, pain, constipation, and diarrhoea. (3) Results: Our prospective study included in the analysis 50 patients with colorectal cancer. The CR 29 questionnaire outlined scores below 30 for sore skin, urinary incontinence, dysuria, faecal incontinence, flatulence, discomfort from bowel movement, sexual dysfunction and hair loss. The CR 30 functioning scale depicted high scores for cognitive (100%, 95% CI [0.91-1]), physical (88%, 95% CI [0.75-0.95]), and functional (88%, 95% CI [0.39-0.68]) domains and low scores (<50) for emotional (98%, 95% CI [0.88-0.99]) and social (100%, 95% CI [0.91-1]) functions. (4) Conclusions: The quality of life of patients with colorectal cancer was influenced by socio-economic status, smoking, surgical procedure, and neoplastic pathology.
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Affiliation(s)
- Florin Mihăileanu
- Department of Surgery—Surgery II, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (F.M.); (S.C.); (I.C.); (B.S.)
| | - Cosmin Andrei Cismaru
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Ariana Anamaria Cordoș
- Department of Surgery—Practical Abilities, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.)
- Romanian Society of Medical Informatics, 300222 Timisoara, Romania
| | - Răzvan Alexandru Ciocan
- Department of Surgery—Practical Abilities, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.)
| | - Stefan Chiorescu
- Department of Surgery—Surgery II, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (F.M.); (S.C.); (I.C.); (B.S.)
| | - Ioana Constantinescu
- Department of Surgery—Surgery II, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (F.M.); (S.C.); (I.C.); (B.S.)
| | - Bogdan Stancu
- Department of Surgery—Surgery II, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (F.M.); (S.C.); (I.C.); (B.S.)
| | - Caius Breazu
- Department of Surgery—Anaesthetics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Horațiu Coman
- Vascular Surgery Clinic, Cluj County Emergency Hospital, 400006 Cluj-Napoca, Romania;
| | - Ioana Berindan Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Claudia Diana Gherman
- Department of Surgery—Practical Abilities, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.)
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Mozooni Z, Shahmohammadi A, Golestani N, Bahadorizadeh L. The Relationship Between Serum and Tissue Levels of IL-13 and TYK2 in Colorectal Cancer Patients. Immunol Invest 2024; 53:1279-1292. [PMID: 39252194 DOI: 10.1080/08820139.2024.2399581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
INTRODUCTION Colorectal cancer (CRC) is a third cause of death worldwide. The immune system plays a significant role in the tumor microenvironment and identifying its components involved in cancer development can aid in finding new biomarkers for prognosis, treatment monitoring, and immune-based therapies. Interleukin 13 (IL-13) is a cytokine produced by immune cells that has been implicated in tumor invasion, proliferation, and metastasis. Previous studies have shown that IL-13 causes the phosphorylation of Tyrosine kinase 2 (TYK2), which may contribute to the development and progression of cancer. This study investigated the levels expression of IL-13 and TYK2 in the tissue and serum of CRC patients and explored their possible association with pathological and clinical factors. METHODS 105 patients with CRC and 105 healthy individuals were involved in the study. Tissue and blood samples were collected. The quantitative Real-Time PCR (qRT-PCR) technique was used to assess the expression levels of the IL-13 and TYK2 CRC tissue samples in comparison with the adjacent control tissue. RESULT The expression levels of IL-13 were lower and TYK2 were found to be higher in CRC tissue compared to normal tissue. Additionally, serum levels of IL-13 were decreased in CRC patients while TYK2 levels were elevated. A significant negative correlation was found between the expression levels of IL-13 in both serum and tissue and the cancer stage. CONCLUSION These results suggest that IL-13 and TYKMay 2 play essential roles in CRC development and progression and may serve as potential biomarkers for early detection and treatment.
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Affiliation(s)
- Zahra Mozooni
- Institute of Immunology and Infectious Diseases, Antimicrobial Resistance Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nafiseh Golestani
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Leyla Bahadorizadeh
- Institute of Immunology and Infectious Diseases, Antimicrobial Resistance Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
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Pennings AJ, Vink GR, van Kuijk S, Melenhorst J, Beets GL, May AM, Breukink SO. Quality of life and functional outcome of rectal cancer patients: A prospective cohort study. Colorectal Dis 2024; 26:1892-1902. [PMID: 39358881 DOI: 10.1111/codi.17181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/07/2024] [Accepted: 08/27/2024] [Indexed: 10/04/2024]
Abstract
AIM In the last decade, the Netherlands has implemented various diagnostic and treatment strategies to enhance rectal cancer outcomes. This study, using data from the Prospective Dutch ColoRectal Cancer (PLCRC) cohort, investigates whether these multidisciplinary advancements have translated into improved health-related quality of life (HRQoL) and functional outcomes for the general Dutch rectal cancer population. METHODS Patients with Stage I-III rectal cancer enrolled in the PLCRC cohort were included. HRQoL and functional outcomes were assessed 1 and 2 years after diagnosis using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EORTC QLQ Colorectal Cancer 29 and the Low Anterior Resection Syndrome score. HRQoL and functional outcomes were compared based on year of diagnosis (2014-2019). RESULTS A total of 1294 patients were included. Two years after diagnosis, patients diagnosed in 2019 (n = 392) had a clinically relevant higher score on physical (8.2, 95% CI 4.1-12.3), role (13.5, 95% CI 7.3-19.7) and social functioning (5.8, 95% CI 0.3-11.2) compared to those diagnosed in 2014 (n = 65). Additionally, patients diagnosed in 2019 experienced less fatigue 2 years after diagnosis compared to those diagnosed in 2014 (-8.6, 95% CI -14.1 to -3.0). The Low Anterior Resection Syndrome score showed no differences. CONCLUSION The findings of this study suggest that over the past decade rectal cancer patients in the Netherlands have witnessed improvements in HRQoL across various domains. Most probably, the improvement is due to a combination of implementation of population screening, a more restrictive neoadjuvant radiotherapy policy and advances in minimally invasive surgery and organ preserving treatment options.
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Affiliation(s)
- Alexander J Pennings
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Geraldine R Vink
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sander van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jarno Melenhorst
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Geerard L Beets
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Stephanie O Breukink
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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9
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Fakih M, Prager GW, Tabernero J, Amellal N, Calleja E, Taieb J. Clinically meaningful outcomes in refractory metastatic colorectal cancer: a decade of defining and raising the bar. ESMO Open 2024; 9:103931. [PMID: 39395264 PMCID: PMC11693422 DOI: 10.1016/j.esmoop.2024.103931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/28/2024] [Accepted: 09/05/2024] [Indexed: 10/14/2024] Open
Abstract
Currently, there is no consensus definition for clinically meaningful outcomes in randomized clinical trials (RCTs) designed to evaluate new treatments for patients with refractory metastatic colorectal cancer (mCRC). Since 2014, recommended targets for improvements in overall survival and progression-free survival have been published by several societies, including those from the American Society of Clinical Oncology (ASCO) Clinically Meaningful Outcomes Working Group in 2014, the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) in 2015, and Colorectal Cancer Canada (CCC) consensus statements in 2019. However, evidence from several systematic reviews suggests that in a substantial proportion of RCTs that led to oncology drug approvals, the recommended thresholds of ASCO and ESMO-MCBS were not met. In addition to efficacy and safety, quality of life (QoL) is important to patients with mCRC, especially for those who are receiving later-line therapy or end-of-life care. As such, both ESMO-MCBS and CCC recommend the inclusion of QoL assessments in the design of mCRC clinical trials. Since the publication of the ASCO recommendations in 2014, there has been significant progress in the development of treatment options for patients with refractory mCRC; these include the approvals of trifluridine/tipiracil (FTD/TPI) as a single agent and in combination with bevacizumab, and the approval of fruquintinib. Among the phase III RCTs in third-line mCRC, only the SUNLIGHT trial of FTD/TPI plus bevacizumab met all recommended thresholds for clinically meaningful improvements, while also demonstrating a manageable safety profile and slower deterioration in multiple measures of QoL compared with FTD/TPI alone. The results from the SUNLIGHT study show that incremental gains in several clinically meaningful endpoints are achievable, thus raising the bar in defining clinically meaningful outcomes for emerging therapies in refractory mCRC.
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Affiliation(s)
- M Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, USA.
| | - G W Prager
- Department of Medicine I, Medical University Vienna, Vienna, Austria
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), IOB-Quiron, Barcelona, Spain
| | - N Amellal
- Servier International Research Institute, Suresnes, France
| | - E Calleja
- Taiho Oncology, Inc., Princeton, USA
| | - J Taieb
- Gastroenterology and Gastrointestinal Oncology Department, Hôpital Européen Georges-Pompidou, University Paris-Cité (Paris Descartes), SIRC CARPEM, Paris, France
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10
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Samara AA, Diamantis A, Magouliotis D, Tolia M, Tsavalas V, Tzovaras G, Tepetes K. Assessing Preoperative (EORTC) QLQ-C30 Score in Elderly Patients with Colorectal Cancer: Results from a Prospective Cohort Study. J Clin Med 2024; 13:6193. [PMID: 39458143 PMCID: PMC11508690 DOI: 10.3390/jcm13206193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/03/2024] [Accepted: 10/08/2024] [Indexed: 10/28/2024] Open
Abstract
Background: In the present study, we aimed to investigate the association between (EORTC) QLQ-C30 scores and both preoperative somatometric parameters and postoperative outcomes in elderly patients undergoing elective surgery for resectable colorectal cancer. Methods: The 118 elderly consecutive patients who underwent colorectal surgery for cancer in a single university's surgical department between 01/2018 and 12/2018 were prospectively enrolled in the present study. All patients with an age > 65 years, diagnosed with resectable colorectal cancer, without metastatic disease, that underwent elective surgery were included prospectively in the present study. Results: Regarding patients' characteristics, a negative correlation between preoperative QLQ (pQLQ) score and age (p = 0.001) and a positive correlation between body mass index (BMI) and pQLQ score (p = 0.048) were observed. Furthermore, there was a statistically significant difference (p = 0.004) in the mean pQLQ score between patients with rectal or colon cancer. Moreover, assessing pQLQ score was a useful tool in terms of postoperative recovery. Negative correlations between the pQLQ score and time (days) of beginning oral feeding (p < 0.001) and length of hospital stay (p = 0.004) were found. The pQLQ score was statistically significantly lower (p = 0.005) in patients who had any postoperative complication; however, there was no difference in patients with major complications. Conclusions: Advanced age, colon cancer and decreased BMI were negatively associated with preoperative QLQ. The assessment of pQLQ in elderly patients with colorectal cancer can be a useful predictive tool for postoperative complications, length of hospital stay and postoperative rehabilitation.
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Affiliation(s)
- Athina A. Samara
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
| | - Alexandros Diamantis
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
| | - Dimitrios Magouliotis
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
| | - Maria Tolia
- Department of Radiotherapy, University of Crete, 73100 Chania, Greece;
| | - Vasileios Tsavalas
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
| | - George Tzovaras
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
| | - Konstantinos Tepetes
- Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece; (A.D.); (D.M.); (V.T.); (G.T.); (K.T.)
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11
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Tran THH, Thanasilp S, Pudtong N. A causal model of health-related quality of life in colorectal cancer patients post-surgery. Eur J Oncol Nurs 2024; 72:102691. [PMID: 39303331 DOI: 10.1016/j.ejon.2024.102691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 08/19/2024] [Accepted: 09/08/2024] [Indexed: 09/22/2024]
Abstract
PURPOSE this study aims to develop and test a model examining the causal relationship between self-efficacy, social support, fatigue, pain, functional status, and health-related quality of life (HRQL). METHODS A cross-sectional correlation study was conducted using a multi-stage sampling technique to recruit 256 individuals aged 20 to 59 with colorectal cancer (CRC) post-surgery from three hospitals in Northern Vietnam. The hypothesized model, based on Ferrans' HRQL conceptual model and literature review, was validated using structural equation modeling (SEM) and Mplus. RESULTS the model fit the data well, explaining 52% of the variance of HRQL. Self-efficacy emerged as the most influential factor directly impacting HRQL (β = .494, p < .05) and also had negative indirect effects on HRQL through fatigue and pain (β = -.271, p < .05). Social support had a positive direct (β = .406, p < .001) and negative indirect effects on HRQL via fatigue and pain (β = -.143, p < .05). Fatigue and pain had negative indirect effects on HRQL through functional status (β = -.336, p < .05 and β = -.219, p < .05, respectively). Functional status had a positive direct effect on HRQL (β = .418, p < .001). CONCLUSIONS The study's findings highlight the importance of improving self-efficacy, social support, and functional status, while reducing fatigue and pain to enhance HRQL among individuals with CRCpost-surgery. These insights can inform the development of targeted interventions to improve the well-being of this population.
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Affiliation(s)
- Thi Hong Hanh Tran
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand; Nam Dinh University of Nursing, Viet Nam.
| | - Sureeporn Thanasilp
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand; Asian Wisdom Care Research Unit, Chulalongkorn University, Bangkok, Thailand.
| | - Noppamat Pudtong
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand; Asian Wisdom Care Research Unit, Chulalongkorn University, Bangkok, Thailand.
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12
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Nakagawa H, Hatanaka S, Kato Y, Matsumoto S, Tanaka K, Sasai H. Association between Physical Activity and Quality of Life in Colorectal Cancer Patients with Postoperative Defecatory Dysfunction: A Preliminary Survey. Healthcare (Basel) 2024; 12:1444. [PMID: 39057587 PMCID: PMC11276377 DOI: 10.3390/healthcare12141444] [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: 06/04/2024] [Revised: 07/14/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
In this study, we aimed to explore the association between physical activity (PA) and quality of life (QoL) in colorectal cancer (CRC) patients with postoperative defecatory dysfunction. A survey using the European Organization for Research and Treatment of Cancer QLQ-30 and QLQ-29 was conducted among 62 adult outpatients with CRC at two cancer hospitals in Japan. PA and sedentary behavior were evaluated using the Global Physical Activity Questionnaire. Multiple regression analysis was performed, incorporating the QoL as the outcome, with the total PA and its three domains (occupational, transportation, and recreational) and sedentary time as exposures, while controlling for age, sex, and tumor location. The analyses revealed that patients engaged in PA ≥ 150 min/week (67.4 points; 95% confidence interval [CI]: 21.1, 113.8) and recreational PA ≥ 30 min/week (56.0 points; 95% CI: 2.3, 109.7) had significantly higher function scores. Conversely, sedentary time >8 h/day or occupational PA duration ≥30 min/week was associated with poor symptom and function scores. These findings highlight the importance of promoting recreational PA and reducing sedentary behavior to maintain and improve the QoL in CRC patients with defecatory dysfunction.
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Affiliation(s)
- Hiromi Nakagawa
- Graduate School of Medicine, Gifu University, Gifu 501-1194, Japan
| | - Sho Hatanaka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan; (S.H.); (H.S.)
| | - Yoshimi Kato
- Uji-Tokushukai Medical Center, Kyoto 611-0041, Japan;
| | | | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan; (S.H.); (H.S.)
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13
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Zhabagin K, Zhabagina A, Shalgumbayeva G, Toleutayeva D, Baissalbayeva A, Toleutayev T, Telmanova Z, Igissin N, Moore M. Quality of Life of Colorectal Cancer Patients: A Literary Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1236-1245. [PMID: 39430145 PMCID: PMC11488553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/14/2023] [Indexed: 10/22/2024]
Abstract
Colorectal cancer (CRC) is a major contributor to global cancer cases and deaths, making it a significant public health concern. As the number of CRC survivors continues to rise, understanding the impact of CRC and its treatment on their quality of life (QoL) has become increasingly important. The determinants of QoL in CRC patients are multifaceted and include physical health, physical fitness, physical activity, healthy eating, psychological health, social support, the availability of high-quality medical care, and QoL at the end of life. These factors interact to shape the overall well-being of CRC survivors. To enhance the QoL of CRC patients, a comprehensive approach is needed. This includes tailoring treatments to individual patient characteristics, providing psychological support and symptom management, promoting post-treatment rehabilitation, organizing support groups, emphasizing early detection, and effectively managing CRC-related symptoms. Addressing these aspects can significantly improve the QOL and well-being of CRC survivors, helping them adapt to life after treatment and thrive in the face of the challenges they may encounter.
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Affiliation(s)
- Kuantkan Zhabagin
- Administrative Department, Semey Nuclear Medicine and Oncology Center, Semey, Kazakhstan
| | - Almagul Zhabagina
- Department of Clinical Oncology and Nuclear Medicine, Semey Medical University, Semey, Kazakhstan
| | | | - Dina Toleutayeva
- Department of Epidemiology and Biostatistics, Semey Medical University, Semey, Kazakhstan
| | - Ainur Baissalbayeva
- Research Department, “UMIT” International Oncological Center of TomoTherapy, Astana, Kazakhstan
| | - Tolegen Toleutayev
- Department of Cardiovascular and Thoracic Surgery Named by B.S.Bulanov, Semey Medical University, Semey, Kazakhstan
| | - Zhansaya Telmanova
- Department of Public Health, Central Asian Institute for Medical Research, Astana, Kazakhstan
- Department of Science, Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan
| | - Nurbek Igissin
- Department of Public Health, Central Asian Institute for Medical Research, Astana, Kazakhstan
- Department of Science, Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University Named after Sh.Ualikhanov, Kokshetau, Kazakhstan
| | - Malcolm Moore
- Department of Science, Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan
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14
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Degu A, Karimi PN, Opanga SA, Nyamu DG. Health-related quality of life among patients with esophageal, gastric, and colorectal cancer at Kenyatta National Hospital. Cancer Rep (Hoboken) 2024; 7:e2038. [PMID: 38507287 PMCID: PMC10953834 DOI: 10.1002/cnr2.2038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/17/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Despite the advancement of modern treatment approaches, several studies indicated a diminished health-related quality of life (HRQoL) in patients with gastrointestinal cancer. However, there is insufficient data about the HRQoL of gastrointestinal cancer patients in Kenya. AIMS The study aimed to investigate HRQoL and its determinants in gastrointestinal cancer patients at Kenyatta National Hospital. METHODS A cross-sectional study was employed among 160 esophageal, 103 gastric, and 96 colorectal cancer patients. The patient list, identified by unique hospital identification numbers, was obtained from records. Eligibility was assessed based on predetermined criteria, and the hospital identification numbers were reshuffled. Study participants were then randomly selected daily during the data collection period. Data were collected using a researcher-administered European Organization for Research and Treatment of Cancer quality of life questionnaire. The data entry and analysis were carried out using Statistical Package for the Social Sciences 26.0 statistical software. A bivariate and multivariate binary logistic regression analysis was employed to investigate determinants of HRQoL at a 0.05 level of significance. RESULTS Most esophageal (N = 118, 73.7%), gastric (N = 75, 72.8%), and colorectal (N = 72, 75%) cancer patients had poor overall HRQoL. In the social (p = .04) and cognitive (p = .02) domain of HRQoL, esophageal cancer patients had a significantly lower mean score as compared to gastric cancer patients. Colorectal cancer patients had the highest mean score in physical functioning (p = .01) as compared with gastric cancer patients. Nonetheless, gastric cancer patients had the highest mean score in emotional functioning domains of quality of life as compared to esophageal (p = .04) and colorectal (p < .001) cancer patients The study revealed a low mean HRQoL score in the majority of the symptom domains of quality of life. A statistically significant difference in all domains of HRQoL was not observed in various treatment modalities of gastrointestinal cancer. Advanced-stage (stages III and IV) and co-morbidities were significant determinants of poor HRQoL. CONCLUSIONS The overall HRQoL of gastrointestinal cancer patients was poor. Advanced-stage cancer and co-morbidities were significant determinants of poor HRQoL. Therefore, intensification of routine monitoring of the disease and the treatments should be actively implemented to improve the HRQoL.
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Affiliation(s)
- Amsalu Degu
- United States International University–Africa, Department of Pharmaceutics and Pharmacy PracticeSchool of Pharmacy and Health SciencesNairobiKenya
- University of Nairobi, Department of PharmacologyClinical Pharmacy and Pharmacy Practices, Faculty of Health SciencesNairobiKenya
| | - Peter N. Karimi
- University of Nairobi, Department of PharmacologyClinical Pharmacy and Pharmacy Practices, Faculty of Health SciencesNairobiKenya
| | - Sylvia A. Opanga
- University of Nairobi, Department of PharmacologyClinical Pharmacy and Pharmacy Practices, Faculty of Health SciencesNairobiKenya
| | - David G. Nyamu
- University of Nairobi, Department of PharmacologyClinical Pharmacy and Pharmacy Practices, Faculty of Health SciencesNairobiKenya
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15
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Haghighatdoost F, Mehrabani-Zeinabad K, Hajihashemi P, Mohammadifard N, Adibi P. Burden of colorectal cancer and its risk factors in the North Africa and Middle East (NAME) region, 1990-2019: a systematic analysis of the global burden of disease study. BMC Public Health 2024; 24:557. [PMID: 38388875 PMCID: PMC10882825 DOI: 10.1186/s12889-024-18027-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE The geographical differences in incidence rates of colorectal cancer (CRC) and its burden due to modifiable risk factors warrant investigating the CRC burden and its risk factors in different regions. In the current study, we aimed to estimate the burden of CRC and the share of its risk factors in the North Africa and Middle East (NAME), from 1990 to 2019. STUDY DESIGN Systematic review. METHODS The rates of incidence, prevalence, death, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) of CRC were estimated through the framework of the Global Burden of Diseases (GBD), Injuries and Risk Factors Study 2019 by age, sex, between 1990 and 2019. The CRC-related DALYs attributable to each lifestyle and metabolic risk factor was also estimated through a comparative risk assessment approach. RESULTS In NAME region, the trends of incidence, prevalence, death, YLL, YLD, and DALYs of CRC were increasing, with higher rates in males than females over this period. High and high-middle socio-demographic index (SDI) countries had greater CRC DALYs rate compared with middle- and low-SDI countries in 2019, except for Palestine [434.66 (95% UI: 368.82, 503.88)]. In NAME region, like the global, dietary risk (33.18%), low whole grain intake (19.79%), and low intake of milk (15.77%) were the major contributing risk factors to DALYs due to CRC in 2019. CONCLUSIONS Due to increasing trend of CRC burden and the considerable role of lifestyle and metabolic factors in its burden in NAME region, implementing fundamental strategies to minimize CRC burden and its risk factors is imperative.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamran Mehrabani-Zeinabad
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Crowder SL, Li X, Himbert C, Viskochil R, Hoogland AI, Gudenkauf LM, Oswald LB, Gonzalez BD, Small BJ, Ulrich CM, Ose J, Peoples AR, Li CI, Shibata D, Toriola AT, Gigic B, Playdon MC, Hardikar S, Bower J, Siegel EM, Figueiredo JC, Jim HSL. Relationships Among Physical Activity, Sleep, and Cancer-related Fatigue: Results From the International ColoCare Study. Ann Behav Med 2024; 58:156-166. [PMID: 38141201 PMCID: PMC10858307 DOI: 10.1093/abm/kaad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Risk factors for cancer-related fatigue are understudied in colorectal cancer. PURPOSE This study aimed to address this critical gap in the literature by (a) describing changes in colorectal cancer-related fatigue and health behavior (physical activity, sleep problems) and (b) examining if physical activity and sleep problems predict fatigue trajectories from baseline (approximately at the time of diagnosis), to 6- and 12 months after enrollment. METHODS Patients participating in the international ColoCare Study completed self-report measures at baseline (approximately time of diagnosis), 6-, and 12 months assessing physical activity using the International Physical Activity Questionnaire (IPAQ) and fatigue and sleep using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Mixed-effect models examined changes in physical activity, sleep problems, and fatigue. Cross-lagged panel models examined bidirectional relationships between physical activity or sleep and fatigue across time. RESULTS Colorectal cancer patients (n = 649) had a mean age of 61 ± 13 years. Most were male (59%), non-Hispanic White (91%), diagnosed with Stages III-IV (56%) colon cancer (58%), and treated with surgery (98%). Within-person cross-lagged models indicated higher physical activity at Month 6 was associated with higher fatigue at Month 12 (β = 0.26, p = .016). When stratified by cancer stage (I-II vs. III-IV), the relationship between physical activity at Month 6 and fatigue at Month 12 existed only for patients with advanced cancer (Stages III and IV, β = 0.43, p = .035). Cross-lagged associations for sleep and fatigue from baseline to Month 6 were only observed in patients with Stages III or IV cancer, however, there was a clear cross-sectional association between sleep problems and fatigue at baseline and Month 6. CONCLUSIONS Within-person and cross-lagged association models suggest fatiguability may become increasingly problematic for patients with advanced colorectal cancer the first year after diagnosis. In addition, sleep problems were consistently associated with higher fatigue in the first year, regardless of cancer stage. TRIAL REGISTRATION The international ColoCare Study was registered on clinicaltrials.gov, NCT02328677, in December 2014.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Caroline Himbert
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Richard Viskochil
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brent J Small
- Department of Behavioral and Community Sciences, School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Cornelia M Ulrich
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jennifer Ose
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Anita R Peoples
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Christopher I Li
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adetunji T Toriola
- Department of Surgery, Washington University St. Louis, St. Louis, MO, USA
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mary C Playdon
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Sheetal Hardikar
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Erin M Siegel
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jane C Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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17
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van Doeveren T, Remmers S, Atema V, van den Bergh RC, Boevé ER, Cornel EB, van der Heijden AG, Hendricksen K, Cauberg EC, Jacobs RA, Kroon BK, Leliveld AM, Meijer RP, Merks B, Oddens JR, Roelofs L, Somford DM, de Vries P, Wijsman B, Windt WA, Zwaan PJ, van Leeuwen PJ, Boormans JL, Aben KK. Short-term Changes in Health-related Quality of Life of Patients Undergoing Radical Surgery for Upper Urinary Tract Urothelial Carcinoma: Results from a Prospective Phase 2 Clinical Trial. EUR UROL SUPPL 2024; 60:15-23. [PMID: 38375344 PMCID: PMC10874848 DOI: 10.1016/j.euros.2023.12.005] [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] [Accepted: 12/11/2023] [Indexed: 02/21/2024] Open
Abstract
Background and objective The possible negative impact of radical surgery on patients' health-related quality of life (HRQoL) plays an important role in preoperative counseling. Here, we analyzed the HRQoL of patients treated for upper urinary tract urothelial carcinoma (UTUC) in the context of a single-arm phase 2 multicenter study, in which the safety and efficacy of a single preoperative intravesical instillation with mitomycin C were investigated. Our objective was to investigate early changes in HRQoL in patients undergoing radical surgery for UTUC and identify factors associated with these outcomes. Methods Patients with pTanyN0-1M0 UTUC were prospectively included. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) questionnaire at baseline, and at 1 and 3 mo after surgery. A linear mixed model was used to evaluate the changes in HRQoL over time and identify the variables associated with these outcomes. The clinical effect size was used to assess the clinical impact and level of perceptibility of HRQoL changes for clinicians and/or patients based on given thresholds. Key findings and limitations Between 2017 and 2020, 186 patients were included. At baseline, 1 mo after surgery, and 3 mo after surgery, response rates were 91%, 84%, and 78%, respectively. One month after surgery, a statistically significant and clinically relevant deterioration was observed in physical, role, and social functioning, and for the included symptom scales: constipation, fatigue, and pain. An improvement in emotional functioning was observed. At 3 mo, HRQoL returned to baseline levels, except emotional functioning, which improved at 1 mo and persisted to be better than that before surgery. Age >70 yr was associated with worse physical functioning, but better social and emotional functioning. Male patients reported better emotional functioning than females. Postoperative complications were negatively associated with social functioning. Conclusions and clinical implications UTUC patients treated with radical surgery experienced a significant, albeit temporary, decline in HRQoL. Three months following surgery, HRQoL outcomes returned to baseline levels. This information can be used to counsel UTUC patients before undergoing radical surgery and contextualize recovery after surgery. Patient summary We investigated the changes in quality of life as reported by patients who underwent surgery for upper tract urothelial carcinoma (UTUC). We found that patients experienced a decline in quality of life 1 mo after surgery, but this was temporary, with full recovery of quality of life 3 mo after surgery. These findings can help doctors and other medical staff in counseling UTUC patients before undergoing radical surgery.
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Affiliation(s)
- Thomas van Doeveren
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Vera Atema
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | | | - Egbert R. Boevé
- Department of Urology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Erik B. Cornel
- Department of Urology, Ziekenhuis Groep Twente, Hengelo, The Netherlands
| | | | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Rens A.L. Jacobs
- Department of Urology, Zuyderland Medical Center, Heerlen and Sittard, The Netherlands
| | - Bin K. Kroon
- Department of Urology, Rijnstate Medical Center, Arnhem, The Netherlands
| | - Annemarie M. Leliveld
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard P. Meijer
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bob Merks
- Department of Urology, Haaglanden Medical Center, Leidschendam, The Netherlands
| | - Jorg R. Oddens
- Department of Urology, AmsterdamUMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Luc Roelofs
- Department of Urology, Treant Zorggroep, Emmen, The Netherlands
| | - Diederik M. Somford
- Department of Urology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Peter de Vries
- Department of Urology, Treant Zorggroep, Emmen, The Netherlands
| | - Bart Wijsman
- Department of Urology, Elisabeth-Tweesteden Medical Center, Tilburg, The Netherlands
| | | | - Peter J. Zwaan
- Department of Urology, Gelre Ziekenhuis, Apeldoorn, The Netherlands
| | - Pim J. van Leeuwen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Joost L. Boormans
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Katja K.H. Aben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Li J, Jiang JL, Chen YM, Lu WQ. KLF2 inhibits colorectal cancer progression and metastasis by inducing ferroptosis via the PI3K/AKT signaling pathway. J Pathol Clin Res 2023; 9:423-435. [PMID: 37147883 PMCID: PMC10397377 DOI: 10.1002/cjp2.325] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/26/2023] [Accepted: 04/16/2023] [Indexed: 05/07/2023]
Abstract
Krüppel-like factor 2 (KLF2) belongs to the zinc finger family and is thought to be a tumor suppressor gene due to its low expression in various cancer types. However, its functional role and molecular pathway involvement in colorectal cancer (CRC) are not well defined. Herein, we investigated the potential mechanism of KLF2 in CRC cell invasion, migration, and epithelial-mesenchymal transition (EMT). We utilized the TCGA and GEPIA databases to analyze the expression of KLF2 in CRC patients and its correlation with different CRC stages and CRC prognosis. RT-PCR, western blot, and immunohistochemistry assays were used to measure KLF2 expression. Gain-of-function assays were performed to evaluate the role of KLF2 in CRC progression. Moreover, mechanistic experiments were conducted to investigate the molecular mechanism and involved signaling pathways regulated by KLF2. Additionally, we also conducted a xenograft tumor assay to evaluate the role of KLF2 in tumorigenesis. KLF2 expression was low in CRC patient tissues and cell lines, and low expression of KLF2 was associated with poor CRC prognosis. Remarkably, overexpressing KLF2 significantly inhibited the invasion, migration, and EMT capabilities of CRC cells, and tumor growth in xenografts. Mechanistically, KLF2 overexpression induced ferroptosis in CRC cells by regulating glutathione peroxidase 4 expression. Moreover, this KLF2-dependent ferroptosis in CRC cells was mediated by inhibiting the PI3K/AKT signaling pathway that resulted in the suppression of invasion, migration, and EMT of CRC cells. We report for the first time that KLF2 acts as a tumor suppressor in CRC by inducing ferroptosis via inhibiting the PI3K/AKT signaling pathway, thus providing a new direction for CRC prognosis assessment and targeted therapy.
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Affiliation(s)
- Jia Li
- Department of General SurgeryShenzhen Traditional Chinese Medicine HospitalShenzhenPR China
| | - Ji Ling Jiang
- Department of General SurgeryShenzhen Traditional Chinese Medicine HospitalShenzhenPR China
| | - Yi Mei Chen
- Department of Breast SurgeryShenzhen Women & Children's Health Care HospitalShenzhenPR China
| | - Wei Qi Lu
- Department of Gastrointestinal SurgeryFirst Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouPR China
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19
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Maryam S, Krukiewicz K, Haq IU, Khan AA, Yahya G, Cavalu S. Interleukins (Cytokines) as Biomarkers in Colorectal Cancer: Progression, Detection, and Monitoring. J Clin Med 2023; 12:jcm12093127. [PMID: 37176567 PMCID: PMC10179696 DOI: 10.3390/jcm12093127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Cancer is the primary cause of death in economically developed countries and the second leading cause in developing countries. Colorectal cancer (CRC) is the third most common cause of cancer-related deaths worldwide. Risk factors for CRC include obesity, a diet low in fruits and vegetables, physical inactivity, and smoking. CRC has a poor prognosis, and there is a critical need for new diagnostic and prognostic biomarkers to reduce related deaths. Recently, studies have focused more on molecular testing to guide targeted treatments for CRC patients. The most crucial feature of activated immune cells is the production and release of growth factors and cytokines that modulate the inflammatory conditions in tumor tissues. The cytokine network is valuable for the prognosis and pathogenesis of colorectal cancer as they can aid in the cost-effective and non-invasive detection of cancer. A large number of interleukins (IL) released by the immune system at various stages of CRC can act as "biomarkers". They play diverse functions in colorectal cancer, and include IL-4, IL-6, IL-8, IL-11, IL-17A, IL-22, IL-23, IL-33, TNF, TGF-β, and vascular endothelial growth factor (VEGF), which are pro-tumorigenic genes. However, there are an inadequate number of studies in this area considering its correlation with cytokine profiles that are clinically useful in diagnosing cancer. A better understanding of cytokine levels to establish diagnostic pathways entails an understanding of cytokine interactions and the regulation of their various biochemical signaling pathways in healthy individuals. This review provides a comprehensive summary of some interleukins as immunological biomarkers of CRC.
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Affiliation(s)
- Sajida Maryam
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 44000, Pakistan
| | - Katarzyna Krukiewicz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
- Centre for Organic and Nanohybrid Electronics, Silesian University of Technology, Konarskiego 22B, 44-100 Gliwice, Poland
| | - Ihtisham Ul Haq
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 44000, Pakistan
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
- Joint Doctoral School, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland
| | - Awal Ayaz Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 44000, Pakistan
| | - Galal Yahya
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Al Sharqia, Egypt
- Department of Molecular Genetics, Faculty of Biology, Technical University of Kaiserslautern, Paul-Ehrlich Str. 24, 67663 Kaiserslautern, Germany
| | - Simona Cavalu
- Faculty of Medicine and Pharmacy, University of Oradea, P-ta 1 Decembrie 10, 410087 Oradea, Romania
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20
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Rutherford C, Ju A, Kim B, Wiltink L, Acret L, White K. How consequences of colorectal cancer treatment are managed: a qualitative study of stakeholder experiences about supportive care and current practices. Support Care Cancer 2023; 31:255. [PMID: 37041401 PMCID: PMC10090022 DOI: 10.1007/s00520-023-07713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Colorectal cancer (CRC) survivors experience treatment-effects such as symptoms and functional impairments. There is limited evidence about how these are managed and what services or supports are available in the community. We aimed to identify current practice and available supports for managing consequences of treatment from clinician and CRC survivor perspectives. METHODS This qualitative study, informed by an interpretivist constructionist paradigm, included semi-structured interviews. Clinicians with experience of treating CRC patients and adult CRC survivors were recruited across Australia. Interviews explored experiences about problems experienced after CRC treatment and how these were managed. Data collection and analysis, using thematic analysis, was iterative whereby emergent themes during analysis were incorporated into subsequent interviews. RESULTS We interviewed 16 clinicians and 18 survivors. Survivors experienced a range of consequences of treatment amendable to support including allied health, information, and self-management. Barriers to support access included clinicians' worry about patient out-of-pocket expenses, long waitlists, lack of awareness about existing supports, and perception no therapeutic options were available. Healthcare professionals with expertise in CRC were often difficult to identify outside of cancer settings. Survivorship care could be improved with individualised timely information and identification of pathways to access healthcare providers with expertise in managing consequences of CRC treatment within primary care. CONCLUSIONS To improve CRC survivor lives posttreatment, routine assessment of consequences of treatment, individualised care planning involving relevant healthcare professionals, access to supportive care when needed, and improved information provision and engagement of a range of health professionals in follow-up care are needed.
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Affiliation(s)
- Claudia Rutherford
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia.
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia.
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.
| | - Angela Ju
- University of Sydney, Faculty Science, School of Psychology, Quality of Life Office, Sydney, Australia
| | - Bora Kim
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Lisette Wiltink
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Louise Acret
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Kate White
- Cancer Care Research Unit (CCRU), Susan Wakil School of Nursing, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Sydney Local Health District, Sydney, Australia
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21
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Hirano T, Negishi M, Kuwatsuru Y, Arai M, Wakabayashi R, Saito N, Kuwatsuru R. Validation of algorithms to identify colorectal cancer patients from administrative claims data of a Japanese hospital. BMC Health Serv Res 2023; 23:274. [PMID: 36944932 PMCID: PMC10029250 DOI: 10.1186/s12913-023-09266-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Administrative claims data are a valuable source for clinical studies; however, the use of validated algorithms to identify patients is essential to minimize bias. We evaluated the validity of diagnostic coding algorithms for identifying patients with colorectal cancer from a hospital's administrative claims data. METHODS This validation study used administrative claims data from a Japanese university hospital between April 2017 and March 2019. We developed diagnostic coding algorithms, basically based on the International Classification of Disease (ICD) 10th codes of C18-20 and Japanese disease codes, to identify patients with colorectal cancer. For random samples of patients identified using our algorithms, case ascertainment was performed using chart review as the gold standard. The positive predictive value (PPV) was calculated to evaluate the accuracy of the algorithms. RESULTS Of 249 random samples of patients identified as having colorectal cancer by our coding algorithms, 215 were confirmed cases, yielding a PPV of 86.3% (95% confidence interval [CI], 81.5-90.1%). When the diagnostic codes were restricted to site-specific (right colon, left colon, transverse colon, or rectum) cancer codes, 94 of the 100 random samples were true cases of colorectal cancer. Consequently, the PPV increased to 94.0% (95% CI, 87.2-97.4%). CONCLUSION Our diagnostic coding algorithms based on ICD-10 codes and Japanese disease codes were highly accurate in detecting patients with colorectal cancer from this hospital's claims data. The exclusive use of site-specific cancer codes further improved the PPV from 86.3 to 94.0%, suggesting their desirability in identifying these patients more precisely.
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Affiliation(s)
- Takahiro Hirano
- Clinical Study Support, Inc., Daiei Bldg., 2F, 1-11-20 Nishiki, Naka-ku, Nagoya, 460-0003, Japan.
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan.
| | - Makiko Negishi
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Shin Nippon Biomedical Laboratories, Ltd., Tokyo, Japan
| | - Yoshiki Kuwatsuru
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Masafumi Arai
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryozo Wakabayashi
- Clinical Study Support, Inc., Daiei Bldg., 2F, 1-11-20 Nishiki, Naka-ku, Nagoya, 460-0003, Japan
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Naoko Saito
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Ryohei Kuwatsuru
- Real-World Evidence and Data Assessment (READS), Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
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22
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Bandyopadhyay R, Dey S, Basu A, Banerjee S. Factors affecting health-related quality of life among patients with colorectal cancer using the european organization for research and treatment of cancer quality of life core questionnaire-CR29. JOURNAL OF MARINE MEDICAL SOCIETY 2023. [DOI: 10.4103/jmms.jmms_181_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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23
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Révész D, van Kuijk SMJ, Mols F, van Duijnhoven FJB, Winkels RM, Kant IJ, van den Brandt PA, Smits LJ, Breukink SO, Kampman E, Beijer S, Weijenberg MP, Bours MJL. External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors. J Clin Epidemiol 2022; 152:127-139. [PMID: 36220623 DOI: 10.1016/j.jclinepi.2022.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/30/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors. STUDY DESIGN AND SETTING In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire-Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains. RESULTS Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores). CONCLUSION Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.
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Affiliation(s)
- Dóra Révész
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, Maastricht 6202 AZ, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands; Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Fränzel J B van Duijnhoven
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Piet A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Luc J Smits
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Stéphanie O Breukink
- Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Martijn J L Bours
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands.
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24
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Cheng V, Oveisi N, McTaggart-Cowan H, Loree JM, Murphy RA, De Vera MA. Colorectal Cancer and Onset of Anxiety and Depression: A Systematic Review and Meta-Analysis. Curr Oncol 2022; 29:8751-8766. [PMID: 36421342 PMCID: PMC9689519 DOI: 10.3390/curroncol29110689] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/28/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022] Open
Abstract
Research suggests that colorectal cancer (CRC) is associated with mental health disorders, primarily anxiety and depression. To synthesize this evidence, we conducted a systematic review and meta-analysis of studies evaluating the onset of anxiety and depression among patients with CRC. We searched EMBASE and Medline from inception to June 2022. We included original, peer-reviewed studies that: used an epidemiologic design; included patients with CRC and a comparator group of individuals without cancer; and evaluated anxiety and depression as outcomes. We used random effects models to obtain pooled measures of associations. Quality assessment was completed using the Newcastle-Ottawa scale. Of 7326 articles identified, 8 were eligible; of which 6 assessed anxiety and depression and 2 assessed depression only. Meta-analyses showed a non-significant association between CRC and anxiety (pooled HR 1.67; 95% CI 0.88 to 3.17) and a significant association between CRC and depression (pooled HR 1.78; 95% CI 1.23 to 2.57). Predictors of anxiety and depression among patients with CRC included clinical characteristics (e.g., comorbidities, cancer stage, cancer site), cancer treatment (e.g., radiotherapy, chemotherapy, colostomy), and sociodemographic characteristics (e.g., age, sex). The impacts of anxiety and depression in patients with CRC included increased mortality and decreased quality of life. Altogether, our systematic review and meta-analysis quantified the risks and impacts of CRC on anxiety and depression, particularly an increased risk of depression after CRC diagnosis. Findings provide support for oncologic care that encompasses mental health supports for patients with CRC.
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Affiliation(s)
- Vicki Cheng
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC V6T 1Z3, Canada
| | - Niki Oveisi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC V6T 1Z3, Canada
| | - Helen McTaggart-Cowan
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Jonathan M. Loree
- Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Rachel A. Murphy
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Mary A. De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC V6Z IY6, Canada
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25
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Mey R, Casaña J, Díaz-Cambronero Ó, Suso-Martí L, Cuenca-Martínez F, Mazzinari G, López-Bueno R, Andersen LL, López-Bueno L, Selva-Sarzo F, Calatayud J. Physical and Quality of Life Changes in Elderly Patients after Laparoscopic Surgery for Colorectal Cancer-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14711. [PMID: 36429445 PMCID: PMC9690118 DOI: 10.3390/ijerph192214711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Background-The incidence of colorectal cancer is increasing among elderly people, where postoperative complications are frequent. Methods-We evaluated postoperative physical and quality of life changes in elderly patients undergoing laparoscopic surgery for colorectal cancer. A prospective cohort study was performed in 31 colorectal cancer patients ≥60 years who were scheduled for laparoscopic surgery due to colorectal cancer. Outcomes were measured one month preoperative (T1), three days postoperative (T2) and one month postoperative (T3). Results-The largest early postoperative (from T1 to T2) declines were observed for isometric knee extension strength (33.1%), 30 s Chair Stand Test (27.9%) and handgrip strength (16.9%). Significant reductions in quality of life measured with the QLQ-C30 summary score and the EQ 5D index score were found between T1-T3 and T1-T2, respectively. Conclusions-A decline in isometric knee extension strength, 30 s Chair Stand Test, handgrip strength and quality of life is evident in elderly patients in the days following laparoscopic surgery for colorectal cancer. Preoperative values are recovered one month after surgery for all the outcomes, except for isometric knee extension, which should receive especial attention.
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Affiliation(s)
- Rochelle Mey
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- VUMC School of Medical Sciences, Amsterdam UMC, 1105 Amsterdam, The Netherlands
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Óscar Díaz-Cambronero
- Department Anesthesiology, Hospital Universitari i Politécnic la Fe, 46010 Valencia, Spain
- Perioperative Medicine Research Group, Biomedical Research Institute la Fe, 46010 Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Guido Mazzinari
- Department Anesthesiology, Hospital Universitari i Politécnic la Fe, 46010 Valencia, Spain
- Perioperative Medicine Research Group, Biomedical Research Institute la Fe, 46010 Valencia, Spain
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Lars L. Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Laura López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | | | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Department Anesthesiology, Hospital Universitari i Politécnic la Fe, 46010 Valencia, Spain
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26
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Hernández-Marín J, Galindo-Vázquez O, Calderillo-Ruíz G, Montero-Pardo X, Costas-Muñiz R, Ortega-Andeane P. [Effect of psychological interventions on psychosocial variables in patients with colorectal cancer: a narrative review of the literature]. PSICOONCOLOGIA 2022; 19:299-318. [PMID: 38756183 PMCID: PMC11097673 DOI: 10.5209/psic.84042] [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] [Indexed: 05/18/2024] Open
Abstract
Objective To describe the effects of psychological interventions on anxiety, depression, emotional distress and/or quality of life (QoL) of patients with colorectal cancer. Methods Narrative literature review in MEDLINE, PsycINFO, CINAHL and Cochrane Library, 2011-2021. Results A total of 553 articles were obtained, of which twelve were included. Most were brief, individual, face-to-face interventions. Cognitive Behavioral Therapy was the most reported intervention, showing positive effects on QoL, specifically in stoma patients; Acceptance and Commitment Therapy and solution-focused therapy also identified improvements in QoL. Reminiscence therapy and a self-efficacy intervention reported significant improvements in anxiety and depression. Relaxation and writing training were not proven effective; psychoeducation showed inconsistent effects. Conclusion There is a paucity of studies conducted during the last years, which do not evidence a consensus of the therapeutic model that produces consistent improvements in psychological well-being.
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Affiliation(s)
- Jazmín Hernández-Marín
- Jazmín Hernández-Marín. Facultad de Psicología. Universidad Nacional Autónoma de México. Ciudad de México, México
| | - Oscar Galindo-Vázquez
- Oscar Galindo-Vázquez. Servicio de Psicooncología, Unidad para la Investigación y Desarrollo de la Psicooncología, Instituto Nacional de Cancerología. INCan. Ciudad de México
| | - Germán Calderillo-Ruíz
- Germán Calderillo-Ruíz. Subdirección de Medicina Interna, Instituto Nacional de Cancerología. INCan. Ciudad de México
| | | | - Rosario Costas-Muñiz
- Rosario Costas-Muñiz. Departamento de Psiquiatría y Ciencias del Comportamiento. Memorial Sloan-Kettering Cancer Center. Cornell Medical College, Estados Unidos
| | - Patricia Ortega-Andeane
- Patricia Ortega-Andeane. Facultad de Psicología, Universidad Nacional Autónoma de México. Ciudad de México, México
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Prospective Evaluation of the Quality of Life of Patients after Surgical Treatment of Rectal Cancer: A 12-Month Cohort Observation. J Clin Med 2022; 11:jcm11195912. [PMID: 36233780 PMCID: PMC9573224 DOI: 10.3390/jcm11195912] [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: 07/26/2022] [Revised: 09/28/2022] [Accepted: 10/05/2022] [Indexed: 12/03/2022] Open
Abstract
This study constitutes a prospective, three-stage evaluation of quality of life among patients receiving surgical treatment for colorectal cancer depending on the type of surgery performed (open anterior resection, laparoscopic anterior resection, abdominoperineal resection, or Hartmann’s procedure). The study included 82 patients treated at the Surgical Oncology Outpatient Department of the Oncology Center in Bydgoszcz from June 2019 to August 2021. The study tools consisted of diagnostic surveys and analyses of medical records. The standardized study tools were the surveys EORTC QLQ-C30 and QLQ-CR29. In addition, a proprietary questionnaire was developed to collect demographic data. Quality of life was measured at three time-points: the day before the surgery and 6 and 12 months post-surgery. Statistically significant differences (p < 0.05) were observed in the domains of role functioning (III, p = 0.030), body image (II, p < 0.001; III, p < 0.001), sexual functioning (II, p = 0.037), buttocks/anal area/rectum pain (III, p = 0.031), and embarrassment (II, p = 0.022; III, p = 0.010). Statistically significant differences in the functional and symptom scale scores were also observed within each group at different stages of cancer treatment. As shown by our study, the quality of life of patients treated for colorectal cancer is determined not only by the operating technique but also by sociodemographic and clinical factors. The use of minimally invasive surgical techniques enables patients to return to their social roles more quickly and improves their self-assessment of body image.
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Al-Shandudi M, Al-Moundhri M, Chan MF, Al-Hajri T, Al-Balushi M, Al-Azri M. Health-Related Quality of Life, Functioning, and Physical Symptoms of Adult Omani Colorectal Cancer Survivors. Asian Pac J Cancer Prev 2022; 23:3019-3027. [PMID: 36172664 PMCID: PMC9810320 DOI: 10.31557/apjcp.2022.23.9.3019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Colorectal (CRC) survivors often experience physical and psychological symptoms affecting their health-related quality of life (HRQoL). This study aimed to identify factors impacting HRQoL-related functioning and physical symptoms among adult Omani CRC survivors. METHODS A cross-sectional study of 124 adult CRC survivors was conducted at the two main oncology referral hospitals in Oman. A validated Arabic version of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire 30 was used to collect data. RESULTS A total of 118 CRC survivors participated in the study (response rate: 95.2%). The mean age was 52 years and there were an equal number of male and female participants (n = 59 each; 50.0%). A total of 62 survivors (52.5%) had been diagnosed with CRC at stages III or IV. The overall score for global health was high (81.7). With regards to functioning, high mean scores were observed for domains of role (91.0) and social (90.7) functioning. In terms of symptoms, high mean scores were reported for constipation (25.4), insomnia (25.1), pain (20.1), and fatigue (18.9). Survivors under 60 years old (β=15.5, p=.004) and those with no comorbidities (β=16.0, p=.001) demonstrated better functional HRQoL. Being male was predictive of better functional HRQoL in the emotional (β=13.9, p<0.008), cognitive functioning (β=12.5, p=.013), role functioning (β=14.0, p=0.006) and physical functioning (β=17.8, p<0.001) domains. CONCLUSIONS Healthcare professionals in Oman should implement measures to enhance the HRQoL of CRC survivors, particularly women and those with coexisting morbidities.
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Affiliation(s)
- Maryam Al-Shandudi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | | | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | | | - Muna Al-Balushi
- Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman.
| | - Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman. ,For Correspondence:
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29
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Ooki A, Morita S, Tsuji A, Iwamoto S, Hara H, Tanioka H, Satake H, Kataoka M, Kotaka M, Kagawa Y, Nakamura M, Shingai T, Ishikawa M, Miyake Y, Suto T, Hashiguchi Y, Yabuno T, Ando M, Sakamoto J, Yamaguchi K. Impact of early tumor shrinkage on quality of life in patients treated with first-line cetuximab plus chemotherapy for unresectable metastatic colorectal cancer: results of Phase II QUACK trial. BMC Cancer 2022; 22:711. [PMID: 35765021 PMCID: PMC9238042 DOI: 10.1186/s12885-022-09811-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/11/2022] [Indexed: 12/09/2022] Open
Abstract
PURPOSE Although early tumor shrinkage (ETS) is a predictor of improved overall survival (OS), the association between ETS and health-related quality of life (HRQOL) remains unclear for patients with metastatic colorectal cancer (mCRC) treated with first-line cetuximab plus chemotherapy. METHODS The data were collected from a prospective trial that assessed HRQOL using the EORTC QLQ-C30. The impact of ETS on HRQOL was estimated using a linear mixed-effects model for repeated measures. RESULTS ETS was achieved in 82 (64.1%) of 128 mCRC patients treated with first-line cetuximab plus chemotherapy, and these patients had a significantly longer OS than those without ETS (HR, 0.38; 95% CI, 0.20-0.72; P = .002). Asymptomatic patients with ETS had a favorable OS, while symptomatic patients without ETS had a worse OS (2-year OS rates, 77.8% vs. 42.5%). Symptomatic patients with ETS had similar outcomes as asymptomatic patients without ETS (2-year OS rates, 64.1% vs. 67.0%). For symptomatic patients, ETS was associated with improved HRQOL scores between baseline and 8 weeks: the mean changes for patients with and without ETS were 5.86 and -4.94 for global health status (GHS)/QOL, 26.73 and 3.79 for physical functioning, and 13.58 and -3.10 for social functioning, respectively. The improved HRQOL was comparable to that of asymptomatic patients without ETS. For asymptomatic patients, ETS showed a decreased deterioration in HRQOL. CONCLUSION Our findings highlight the importance of ETS for HRQOL and prognostic estimates, and assessing ETS may provide clinically useful information for physicians and patients to make more informed decisions.
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Affiliation(s)
- Akira Ooki
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University, Kyoto, Japan
| | - Akihito Tsuji
- Department of Medical Oncology, Kagawa University, Kita, Japan
| | - Shigeyoshi Iwamoto
- Department of Surgery, Kansai Medical University Kouri Hospital, Neyagawa, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Hiroaki Tanioka
- Department of Clinical Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Hironaga Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Osaka, Japan
| | - Masato Kataoka
- Department of Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | | | - Masato Nakamura
- Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Tatsushi Shingai
- Department of Surgery, Osaka Saiseikai Senri Hospital, Suita, Japan
| | - Masashi Ishikawa
- Department of Surgery, Shikoku Central Hospital, Shikokuchuo, Japan
| | - Yasuhiro Miyake
- Department of Surgery, Osaka Minato Central Hospital, Osaka, Japan
| | - Takeshi Suto
- Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Yojiro Hashiguchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Taichi Yabuno
- Department of Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masahiko Ando
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | - Kensei Yamaguchi
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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30
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Querido NR, Kenkhuis MF, van Roekel EH, Breukink SO, van Duijnhoven FJB, Janssen-Heijnen ML, Keulen ET, Ueland PM, Vogelaar FJ, Wesselink E, Bours MJ, Weijenberg MP. Longitudinal associations between inflammatory markers and fatigue up to two years after colorectal cancer treatment. Cancer Epidemiol Biomarkers Prev 2022; 31:1638-1649. [PMID: 35654354 DOI: 10.1158/1055-9965.epi-22-0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fatigue is often reported by colorectal cancer survivors (CRC) and largely impacts their quality of life. Inflammation has been linked to fatigue mainly in breast cancer patients. Therefore, we investigated how inflammation is longitudinally associated with fatigue in CRC survivors, up to 2 years post-treatment. METHODS A total of 257 patients from the ongoing Energy for life after ColoRectal cancer (EnCoRe) cohort study were included in the analysis. Plasma levels of IL6, IL8, IL10, TNFα, hsCRP, and fatigue were measured at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was measured through the validated Checklist Individual Strength (CIS total, 20-140), consisting of four subscales - subjective fatigue (8-56), motivation (4-28), physical activity (3-21), and concentration (5-35), and the EORTC QLQ-C30 fatigue subscale (0-100). Linear mixed-models were used to assess the confounder-adjusted longitudinal associations between inflammatory markers and overall fatigue along with the subscales. RESULTS Mean levels of CIS fatigue decreased from 62.9 at 6 weeks to 53.0 at 24 months. In general, levels of inflammatory markers also decreased over time. No statistically significant longitudinal associations were found between IL6, IL8, IL10, TNFα, and fatigue. Higher levels of hsCRP were associated with more CIS fatigue (β per SD 3.21, 95% CI 1.42; 5.01) and EORTC fatigue (β 2.41, 95% CI 0.72; 4.10). CONCLUSION Increased levels of hsCRP are longitudinally associated with more post-treatment fatigue in CRC survivors. IMPACT These findings suggest that low-grade inflammation may play a role in fatigue reported by CRC survivors up to 2 years post-treatment.
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31
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Kopetz S, Grothey A, Van Cutsem E, Yaeger R, Wasan H, Yoshino T, Desai J, Ciardiello F, Loupakis F, Hong YS, Steeghs N, Guren TK, Arkenau HT, Garcia-Alfonso P, Belani A, Zhang X, Tabernero J. Quality of life with encorafenib plus cetuximab with or without binimetinib treatment in patients with BRAF V600E-mutant metastatic colorectal cancer: patient-reported outcomes from BEACON CRC. ESMO Open 2022; 7:100477. [PMID: 35653981 PMCID: PMC9271477 DOI: 10.1016/j.esmoop.2022.100477] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background In the BEACON CRC study (NCT02928224), encorafenib plus cetuximab with binimetinib {9.3 versus 5.9 months; hazard ratio (HR) [95% confidence interval (CI)]: 0.60 [0.47-0.75]} or without binimetinib [9.3 versus 5.9 months; HR (95% CI): 0.61 (0.48-0.77)] significantly improved overall survival (OS) compared with the previous standard of care (control) in patients with BRAF V600E metastatic colorectal cancer (mCRC). Quality of life (QoL) was a secondary endpoint, assessed using validated instruments. Patients and methods BEACON CRC was a randomized, open-label, phase III study comparing encorafenib plus cetuximab with or without binimetinib and the investigator’s choice of irinotecan plus cetuximab or FOLFIRI plus cetuximab (chemotherapy control) in patients with previously treated BRAF V600E mCRC. Patient-reported QoL assessments included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC) and Functional Assessment of Cancer Therapy—Colorectal (FACT-C). The primary outcome for these tools was time to definitive 10% deterioration. Results Encorafenib plus cetuximab, both with and without binimetinib, was associated with longer median times to definitive 10% deterioration versus the control group in the EORTC Global Health Status scale [HR (95% CI): 0.65 (0.52-0.80) versus 0.61 (0.49-0.75), respectively] and the FACT-C functional well-being subscale [HR (95% CI): 0.62 (0.50-0.76) versus 0.58 (0.47-0.72), respectively]. Consistent results were observed across all subscales of the EORTC and FACT-C instruments. QoL was generally maintained during treatment for the global EORTC and FACT-C scales. Conclusions In addition to improving OS, encorafenib plus cetuximab with or without binimetinib delays QoL decline in previously treated patients with BRAF V600E-mutant mCRC.
BEACON CRC compares encorafenib + cetuximab ± binimetinib to chemotherapy in previously treated BRAF V600E mCRC. Encorafenib + cetuximab had longer time to 10% deterioration versus control in QoL and functional well-being scales. Encorafenib + cetuximab ± binimetinib delays QoL decline in previously treated patients with BRAF V600E mCRC.
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Affiliation(s)
- S Kopetz
- University of Texas MD Anderson Cancer Center, Houston, USA.
| | - A Grothey
- West Cancer Center and Research Institute, OneOncology, Germantown, USA
| | - E Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
| | - R Yaeger
- Memorial Sloan-Kettering Cancer Center, New York, USA
| | - H Wasan
- Hammersmith Hospital, Department of Cancer Medicine, London, UK
| | - T Yoshino
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Desai
- Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Walter and Aliza Hall Institute, Parkville, Australia
| | | | - F Loupakis
- Istituto Oncologico del Veneto IRCCS, Padova, Italy
| | - Y S Hong
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - N Steeghs
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T K Guren
- Oslo University Hospital, Department of Oncology, Oslo, Norway
| | - H-T Arkenau
- Sarah Cannon Research Institute, University College of London, London, UK
| | | | | | | | - J Tabernero
- Vall d'Hebron Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
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Duineveld LAM, Wieldraaijer T, Govaert MJPM, Busschers WB, Wind J, van Asselt KM, van Weert HCPM. Symptoms and seeking supportive care and associations with quality of life after treatment for colon cancer: Results from the I CARE cohort study. Eur J Cancer Care (Engl) 2022; 31:e13601. [PMID: 35470519 PMCID: PMC9540810 DOI: 10.1111/ecc.13601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 12/28/2021] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Patients treated for colon cancer report many symptoms that affect quality of life (QoL). Survivorship care aims at QoL improvement. In this study, we assess associations between symptoms and seeking supportive care and lower QoL and QoL changes overtime during survivorship care. METHODS A prospective cohort of colon cancer survivors. Questionnaires are administered at inclusion and 6 months later to evaluate symptoms, functioning and seeking supportive care including associations with QoL, using the EORTC QLQ-C30. RESULTS The mean QoL score at the first questionnaire was 82 (scale 1-100), which improved over time. Pain, bowel symptoms and problems in physical, role, cognitive or social functioning are associated with lower QoL at inclusion but are not associated with QoL changes over time. Seeking support for lower bowel symptoms, physical functioning or fatigue is associated with lower QoL. After 6 months, seeking support for upper bowel symptoms or physical functioning is associated with a tendency towards less QoL improvement. CONCLUSION QoL of colon cancer survivors improves over 6 months, but seeking support for specific symptoms barely contribute to this improvement. IMPLICATIONS This study confirms the importance of addressing symptoms, problems related to functioning and seeking supportive care during survivorship care.
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Affiliation(s)
| | - Thijs Wieldraaijer
- Department of Primary Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | | | - Wim B Busschers
- Department of Primary Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Jan Wind
- Department of Primary Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of Primary Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Henk C P M van Weert
- Department of Primary Care, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
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Cheng YX, Liu XY, Kang B, Tao W, Wei ZQ, Peng D. Comparison of surgical and oncologic outcomes in very elderly patients (≥ 80 years old) and elderly (65-79 years old) colorectal cancer patients: a propensity score matching. BMC Gastroenterol 2022; 22:205. [PMID: 35468733 PMCID: PMC9036748 DOI: 10.1186/s12876-022-02277-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/05/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose The purpose of this study was to investigate the short-term outcomes and prognosis of elderly and very elderly colorectal cancer (CRC) patients after primary CRC surgery using propensity score matching (PSM). Methods This study retrospectively collected the medical records of CRC patients ≥ 65 years old undergoing primary CRC surgery from Jan 2011 to Jan 2020. Short-term outcomes, overall survival (OS) and disease-free survival (DFS) were compared between very elderly CRC patients (≥ 80 years old) and elderly CRC patients (65–79 years old). Results A total of 2084 patients were enrolled for analysis. After PSM, 331 very elderly patients were matched to 331 elderly patients. In terms of short-term outcomes, the very elderly patients had longer postoperative hospital stays (p = 0.007) after PSM. In terms of OS, it was found that age (p < 0.01, HR = 1.878, 95% CI 1.488–2.371), tumor stage (p < 0.01, HR = 1.865, 95% CI 1.603–2.170), overall complications (p < 0.01, HR = 1.514, 95% CI 1.224–1.872) and major complications (p = 0.001, HR = 2.012, 95% CI 1.319–3.069) were independent prognostic factors. For DFS, age (p < 0.01, HR = 1.816, 95% CI 1.579–2.088), tumor stage (p < 0.01, HR = 1.816, 95% CI 1.579–2.088), overall complications (p = 0.002, HR = 1.379, 95% CI 1.128–1.685) and major complications (p = 0.002, HR = 1.902, 95% CI 1.259–2.874) were found to be independent prognostic factors. Moreover, elderly patients had a better OS and DFS than very elderly patients. Conclusion Very elderly patients had a poorer prognosis than elderly patients after primary CRC surgery. Surgeons should be cautious when treating very elderly CRC patients.
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Affiliation(s)
- Yu-Xi Cheng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China
| | - Bing Kang
- Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Tao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China.
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Legg M, Meertens RM, van Roekel E, Breukink SO, Janssen ML, Keulen ETP, Steindorf K, Weijenberg MP, Bours M. The Association between Sleep Quality and Fatigue in Colorectal Cancer Survivors up until Two Years after Treatment: A Cross-Sectional and Longitudinal Analysis. Cancers (Basel) 2022; 14:cancers14061527. [PMID: 35326678 PMCID: PMC8945971 DOI: 10.3390/cancers14061527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Fatigue is a distressing complaint with high detriment to quality of life that persists in one third of colorectal cancer survivors after cancer treatment. Surprisingly, the contribution of poor sleep quality to fatigue in colorectal cancer survivors is underinvestigated. We aimed to investigate the association between sleep quality and fatigue in colorectal cancer survivors up until two years post-treatment. Results showed worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment. The results of this study suggest that more attention for sleep quality in colorectal cancer survivors and offering sleep health interventions may lead to less fatigue and better quality of life in this group. Abstract Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.
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Affiliation(s)
- Meera Legg
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Ree M. Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Eline van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands;
| | - Maryska L. Janssen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands;
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands;
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany;
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
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35
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Yu YQ, Ma L, Wang WJ, Zhao YQ, Xu HF, Cao J, Li L, Hao JQ, Gao JR, Gu XF, Liu YY, Huang JX, Fan YP, Du LB, Cao HL, Feng CY, Zhu Q, Wang XH, Du JC, Bangura MS, Zhang X, Zhang SK, Qiao YL. Health-related quality of life in advanced colorectal cancer patients in China: a nationwide hospital-based survey. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:328. [PMID: 35433947 PMCID: PMC9011208 DOI: 10.21037/atm-22-991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is one of the most common cancers in China, and most CRC patients have already reached an advanced stage by the time of initial diagnosis. Due to the loss of health as a result of cancer, it has consequence on the treatment which may affect the psychophysical and social impairment of CRC patients. These indicators (psychophysical, function and social impairment) affect the health-related quality of life (HRQOL). There are limited studies that focus on advanced CRC patients in China. This study aimed to assess the HRQOL and its associated factors of advanced CRC patients in China. Methods This was a cross-sectional, nationwide, hospital-based, and multi-center survey. According to the traditional administrative district definition, we selected 19 hospitals in 7 regions by multi-stage stratified sampling in China. For each eligible CRC patient with stage III or IV in the selected hospitals, socio-demographics, clinical information, and HRQOL were collected based on patients’ self-reporting and/or medical records between March 2020 and March 2021. Patients completed the Functional Assessment of Cancer Therapy Colorectal (FACT-C) plus-traditional Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-9. Results A total of 4,589 CRC patients (mean age 60.1 years, including 2,730 males and 1,859 females) were included. The total score of HRQOL in population was 128.2±24.70. There were significant differences in the overall score of HRQOL in gender, education level, occupation, region, disease type, and disease stage (P<0.05). The score of HRQOL was better in males, undergraduates and above, unemployed/laid-off, and southwestern and central China. Multivariate analysis showed that education level, occupation, location, number of hospitals visited and treatment methods, and gender were associated with utilities of CRC patients. Conclusions The HRQOL is an important outcome measure for CRC patients. The HRQOL scores differed according to socio-demographic and clinical characteristics, and findings of these factors were associated with education level, occupation, region, number of visited and treatment methods, and gender.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jin-Qi Hao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Jing-Ru Gao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | | | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Ilic-Zivojinovic J, Krdzic I, Jovanovic A, Vukasinovic D, Ilic B, Gavrilovic A, Soldatovic I. Transcultural adaptation and validation of the Serbian version of the colorectal-specific quality of life questionnaire FACT-C. PLoS One 2022; 17:e0263110. [PMID: 35113936 PMCID: PMC8812893 DOI: 10.1371/journal.pone.0263110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/12/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Transcultural adaptation and validation of the FACT-C questionnaire to Serbian language. METHODS The study included 131 patients with colorectal cancer. Translation included standard forward and backward translation from original language to Serbian and back. Pilot testing of the questionnaire was conducted on 10 patients with diagnosed colorectal cancer. The questionnaires EORTC-QLQ-C30 and DASS will be used as validated tools to evaluate validity of examined, FACT-C questionnaire. RESULTS The FACT-C demonstrated satisfactory construct validity using Cronbach's alpha. Satisfactory concurrent validity was demonstrated using correlations with EORTC-QLQ-C30 and DASS questionnaires. High reproducibility was demonstrated using repeated questionnaires on 30 patients two weeks after the first interview. CONCLUSION The Serbian version of the FACT-C was demonstrated to have satisfactory applicability, reliability and validity in Serbian patients with colorectal cancer. It can be considered as a valid colorectal cancer specific health related quality of life tool for the Serbian population.
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Affiliation(s)
- Jelena Ilic-Zivojinovic
- Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia
| | - Igor Krdzic
- Department of Colorectal Surgery, University Clinical Hospital Center Zvezdara, Surgery Clinic “Nikola Spasić”, Belgrade, Serbia
| | - Ana Jovanovic
- Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia
| | - Danka Vukasinovic
- Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia
| | - Branislav Ilic
- School of Dental Medicine, Clinic for Oral Surgery, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Gavrilovic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Clinic of Neurology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Ivan Soldatovic
- Faculty of Medicine, Institute of Medical Statistics and Informatic, University of Belgrade, Belgrade, Serbia
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Kenkhuis MF, Mols F, van Roekel EH, Breedveld-Peters JJL, Breukink SO, Janssen-Heijnen MLG, Keulen ETP, van Duijnhoven FJB, Weijenberg MP, Bours MJL. Longitudinal Associations of Adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Lifestyle Recommendations with Quality of Life and Symptoms in Colorectal Cancer Survivors up to 24 Months Post-Treatment. Cancers (Basel) 2022; 14:417. [PMID: 35053579 PMCID: PMC8774035 DOI: 10.3390/cancers14020417] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 11/24/2022] Open
Abstract
Post-treatment adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations were associated with health-related quality of life (HRQoL), fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer (CRC) survivors. In a prospective cohort among CRC survivors (n = 459), repeated home-visits were performed at 6 weeks, 6, 12, and 24 months post-treatment. Dietary intake, body composition, sedentary behaviour, and physical activity were assessed to construct a lifestyle score based on adherence to seven 2018 WCRF/AICR recommendations. Longitudinal associations of the lifestyle score with HRQoL, fatigue, and CIPN were analysed by confounder-adjusted linear mixed models. A higher lifestyle score was associated with better physical functioning and less activity-related fatigue, but not with CIPN. Adjustment for physical activity substantially attenuated observed associations, indicating its importance in the lifestyle score with regards to HRQoL. In contrast, adjustment for body composition and alcohol inflated observed associations, indicating that both recommendations had a counteractive influence within the lifestyle score. Our findings suggest that CRC survivors benefit from an overall adherence to the WCRF/AICR lifestyle recommendations in terms of HRQoL and fatigue, but not CIPN. Specific recommendations have a varying influence on these associations, complicating the interpretation and requiring further study.
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Affiliation(s)
- Marlou-Floor Kenkhuis
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
| | - Floortje Mols
- Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands;
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
| | - José J. L. Breedveld-Peters
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands;
| | - Maryska L. G. Janssen-Heijnen
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
- Department of Clinical Epidemiology, Viecuri Medical Center, 5912 BL Venlo, The Netherlands
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre Sittard-Geleen, 6162 BG Geleen, The Netherlands;
| | | | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
| | - Martijn J. L. Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6211 LK Maastricht, The Netherlands; (E.H.v.R.); (J.J.L.B.-P.); (M.L.G.J.-H.); (M.P.W.); (M.J.L.B.)
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Al-Shandudi M, Al-Mandhari M, Chan MF, Al-Hajri T, Al-Balushi M, Al-Azri M. Health-Related Quality of Life of Omani Colorectal Cancer Survivors. Cancer Control 2022; 29:10732748221084198. [PMID: 35275768 PMCID: PMC8921743 DOI: 10.1177/10732748221084198] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) patients often experience physical and psychological symptoms which affect quality of life (QOL). PURPOSE This study aimed to identify factors affecting QOL among adult Omani CRC survivors. METHODS A prospective cross-sectional study of 124 adult CRC survivors was conducted at the two main oncology referral hospitals in Oman. A validated Arabic version of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire for Colorectal Cancer-29 (EORTC QLQ-CR29) was used to collect data. RESULTS Of the 118 participants (response rate: 95.2%), 59 (50.0%) were male. The mean age was 52.7 years. Overall, 102 (86.4%) had been diagnosed with CRC at stages II or III. High mean scores on the QLQ-CR29 functional scale were reported for body image (88.9), weight (79.3), and anxiety (75.4). Mean scores for sexual interest were lower in men (31.4) compared to women (62.2). Severe anxiety was reported in 12 survivors (10.2%). Age, gender, the presence of comorbidities, and tumor location were significant predictors of QOL (P ≤.05). CONCLUSION Omani CRC survivors demonstrated satisfactory QOL, although men reported more anxiety and sexual problems. Healthcare providers in Oman should conduct regular assessments of CRC survivors and offer counseling services if necessary.
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Affiliation(s)
- Maryam Al-Shandudi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, Muscat, Oman
| | - Mansour Al-Mandhari
- Sultan Qaboos Comprehensive Cancer Care & Research Center, 37611Sultan Qaboos University, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, Muscat, Oman
| | | | - Muna Al-Balushi
- Sultan Qaboos Comprehensive Cancer Care & Research Center, 37611Sultan Qaboos University, Muscat, Oman
| | - Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, 37611Sultan Qaboos University, Muscat, Oman
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Qaderi SM, van der Heijden JAG, Verhoeven RHA, de Wilt JHW, Custers JAE. Trajectories of health-related quality of life and psychological distress in patients with colorectal cancer: A population-based study. Eur J Cancer 2021; 158:144-155. [PMID: 34666216 DOI: 10.1016/j.ejca.2021.08.050] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/16/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this nationwide cohort study was to examine the course of symptoms and trajectories of health-related quality of life (HR-QoL) and psychological distress during follow-up and to identify vulnerable patients. METHODS Patients with pathological stage I-III colorectal cancer (CRC) between 2013 and 2018 were included. Baseline characteristics were collected from the Netherlands Cancer Registry, and patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30/CR29, Hospital Anxiety and Depression Scale and low anterior resection syndrome (LARS) questionnaires at the baseline and subsequently at 3, 6, 12, 18 and 24 months. Latent class growth and multinomial logistic regression analyses were performed to outline 24-month trajectories in HR-QoL and distress and to identify predictive factors. RESULTS A total of 1535 patients with colon cancer or rectal cancer were included. Trajectory analysis of HR-QoL identified three patient classes: high HR-QoL (62.7%), improving HR-QoL (29.0%) and low HR-QoL (8.3%). The following patient groups were identified with having low distress (64.0%), moderate distress (26.9%) and high distress (9.1%). Around 13% of the total cohort had either persistent low HR-QoL or high psychological distress throughout follow-up. Patients belonging to this vulnerable group were significantly more likely to be female, to be younger aged, to have lower education, to have disease stage II-III or to have major LARS. CONCLUSIONS Although most patients treated for stage I-III CRC fared well, a small but significant proportion of around 13% did not recover during follow-up and reported low HR-QoL and/or high psychological distress levels throughout. This study's findings should be taken into account when organising and selecting patients for tailored follow-up.
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Affiliation(s)
- Seyed M Qaderi
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands.
| | - Joost A G van der Heijden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Rob H A Verhoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Amsterdam UMC, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Johannes H W de Wilt
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Jose A E Custers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, the Netherlands
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Tiselius C, Rosenblad A, Strand E, Smedh K. Risk factors for poor health-related quality of life in patients with colon cancer include stoma and smoking habits. Health Qual Life Outcomes 2021; 19:216. [PMID: 34507560 PMCID: PMC8431914 DOI: 10.1186/s12955-021-01850-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/26/2021] [Indexed: 01/04/2023] Open
Abstract
Background Previous studies have shown that health-related quality of life (HRQoL) is associated with the prognosis of cancer patients. The aim of this study was to investigate risk factors for poor HRQoL in patients with colon cancer. Methods This was a prospective population-based study of patients with colon cancer included between 2012 and 2016. HRQoL was measured using the cancer-specific European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Multiple linear regression analysis adjusted for age, sex, body mass index, smoking habits, American Society of Anesthesiologists physical status classification, emergency/elective surgery, resection with/without a stoma and tumour stage was used. Results A total of 67% (376/561) of all incident patients with colon cancer (196 [52.1%] females) was included. Mean (range) age was 73 (30–96) years. Patients with worse health (American Society of Anesthesiologists physical status 3 and 4), those with higher body mass index, smokers and those planned to undergo surgical treatment with a stoma were at a higher risk for poor HRQoL than the other included patients at baseline and 6-month follow-up. Conclusions Patient characteristics such as smoking, high body mass index and worse physical health as well as treatment with a stoma were associated with lower HRQoL. Health care for such patients should focus on social and lifestyle behavioural support and stoma closure, when possible. Trial registration: ClinicalTrials.gov (NCT 03910894).
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Affiliation(s)
- Catarina Tiselius
- Department of Surgery, Västmanland Hospital Västerås, Västerås, Sweden. .,Centre for Clinical Research Västerås, Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden.
| | - Andreas Rosenblad
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden
| | - Eva Strand
- Department of Surgery, Västmanland Hospital Västerås, Västerås, Sweden
| | - Kenneth Smedh
- Department of Surgery, Västmanland Hospital Västerås, Västerås, Sweden.,Centre for Clinical Research Västerås, Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden
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Piringer G, Holzner B, Mayrbaeurl B, Heibl S, Sztankay M, Frantal S, Gnant M, Thaler J. Influence of a Structured Exercise Training on Patients Reported Quality of Life in Colorectal Cancer Patients After Adjuvant Chemotherapy: A Pilot Study. Integr Cancer Ther 2021; 19:1534735420938458. [PMID: 32735463 PMCID: PMC7401055 DOI: 10.1177/1534735420938458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose: Cancer and its treatment strategies can have adverse effects on physical functioning and quality of life. Treatment strategies for better quality of life are still an unresolved issue. Physical activity is a promising treatment strategy that still has to be fully investigated. Methods: The ABCSG C07-EXERCISE study evaluated the feasibility of a 1-year exercise training after adjuvant chemotherapy in colorectal cancer patients. The present report presents the patient-reported outcomes during the exercise training. Fourteen patients of one center filled out the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) questionnaire at 5 time points after initiating a 1-year exercise training. Results: At baseline, patients scored social functioning, emotional functioning, financial impact, insomnia, and diarrhea much worse than the German general population. After 1 year of a structured exercise training, a large improvement was reported for social functioning; moderate improvements were reported for pain, diarrhea, financial impact, and taste; and a small change for physical and emotional functioning as well as for global quality of life. Conclusions: The present study observed improvements of social, physical, and emotional functioning as well as global quality of life after 1 year of a structured exercise training in patients with locally advanced colorectal cancer after receiving adjuvant chemotherapy. To enhance compliance, sufficient support and different sport facilities should be offered. The positive effect of exercise on patient-reported outcomes, disease-free survival, and overall survival in cancer survivors have to be further investigated in further randomized clinical trials.
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Affiliation(s)
- Gudrun Piringer
- Klinikum Wels-Grieskirchen, Wels, Austria.,Johannes Kepler University Linz, Linz, Austria
| | | | - Beate Mayrbaeurl
- Klinikum Wels-Grieskirchen, Wels, Austria.,Johannes Kepler University Linz, Linz, Austria
| | - Sonja Heibl
- Klinikum Wels-Grieskirchen, Wels, Austria.,Johannes Kepler University Linz, Linz, Austria
| | | | - Sophie Frantal
- Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria
| | | | - Josef Thaler
- Klinikum Wels-Grieskirchen, Wels, Austria.,Johannes Kepler University Linz, Linz, Austria
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De Luca R, Lo Coco G, Addeo R, Fattoruso SIS, Auriemma A, Paci R, Mistretta O, Epifanio MS, Salvato A, D'Agostino A, Cicero G. Quality of Life in Patients With Severe Skin Reactions in Course of First-Generation Epidermal Growth Factor Receptor Inhibitors Monoclonal Antibodies (Our Experience With Cetuximab). World J Oncol 2021; 12:104-110. [PMID: 34349854 PMCID: PMC8297050 DOI: 10.14740/wjon1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 11/11/2022] Open
Abstract
Background Metastatic colorectal cancer (mCRC) with wild type expression of RAS and RAF genes can be treated with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies, such as cetuximab, in combination with chemotherapy. Skin toxicity represents the most serious and frequent side effect in these patients. Skin manifestations occur in approximately 80% of patients. In this study, we investigated the consequences on body image and quality of life (QoL) of patients with severe skin toxicity. Methods One hundred patients were enrolled with mCRC. All patients signed informed consent and completed questionnaires to assess QoL and body discomfort. Toxicity was assessed on Common Terminology Criteria for Adverse Events (CTCAEs). Results The greatest impact on QoL was represented by difficulties in managing skin rash-related side effects. Data showed a significant impact in psychological sphere and social relationships. Conclusions Skin side effects, particularly rash, influence QoL and social relationships, compromising therapeutic compliance.
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Affiliation(s)
- Rossella De Luca
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Raffaele Addeo
- Oncology Operative Unit, Hospital of Frattamaggiore (NA), ASLNA2NORD, Italy
| | | | | | - Roberta Paci
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Ornella Mistretta
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Maria Stella Epifanio
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Angela Salvato
- Oncology Operative Unit, Hospital of Frattamaggiore (NA), ASLNA2NORD, Italy
| | - Alberto D'Agostino
- Surgery Unit and Trauma Center, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Giuseppe Cicero
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
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Associations of the dietary World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations with patient-reported outcomes in colorectal cancer survivors 2-10 years post-diagnosis: a cross-sectional analysis. Br J Nutr 2021; 125:1188-1200. [PMID: 33087189 DOI: 10.1017/s0007114520003487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) advise cancer survivors to follow their lifestyle recommendations for cancer prevention. Adhering to these recommendations may have beneficial effects on patient-reported outcomes after a cancer diagnosis, but evidence is scarce. We aimed to assess associations of the individual dietary WCRF/AICR recommendations regarding fruit and vegetables, fibre, fast foods, red and processed meat, sugar-sweetened drinks and alcohol consumption with patient-reported outcomes in colorectal cancer (CRC) survivors. Cross-sectional data of 150 stage I-III CRC survivors, 2-10 years post-diagnosis, were used. Dietary intake was measured by 7-d dietary records. Validated questionnaires were used to measure health-related quality of life (HRQoL), fatigue and neuropathy. Confounder-adjusted linear regression models were used to analyse associations of each WCRF/AICR dietary recommendation with patient-reported outcomes. Higher vegetable intake (per 50 g) was associated with better global QoL (β 2·6; 95 % CI 0·6, 4·7), better physical functioning (3·3; 1·2, 5·5) and lower levels of fatigue (-4·5; -7·6, -1·4). Higher fruit and vegetables intake (per 100 g) was associated with better physical functioning (3·2; 0·8, 5·5) and higher intake of energy-dense food (per 100 kJ/100 g) with worse physical functioning (-4·2; -7·1, -1·2). No associations of dietary recommendations with neuropathy were found. These findings suggest that adhering to specific dietary WCRF/AICR recommendations is associated with better HRQoL and less fatigue in CRC survivors. Although the recommendations regarding healthy dietary habits may be beneficial for the well-being of CRC survivors, longitudinal research is warranted to gain insight into the direction of associations.
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Nusca SM, Parisi A, Mercantini P, Gasparrini M, Pitasi FA, Lacopo A, Colonna V, Stella G, Cerulli C, Grazioli E, Tranchita E, Santoboni F, Latini E, Trischitta D, Vetrano M, Visco V, Pavan A, Vulpiani MC. Evaluation of a Post-Operative Rehabilitation Program in Patients Undergoing Laparoscopic Colorectal Cancer Surgery: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115632. [PMID: 34070340 PMCID: PMC8197504 DOI: 10.3390/ijerph18115632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 01/07/2023]
Abstract
This pilot study explores the effects of a post-operative physical exercise program on the quality of life (QoL) and functional and nutritional parameters of patients that underwent laparoscopic colorectal cancer surgery, compared to usual care alone. The intervention group (IG) attended a 2-month-long supervised and combined exercise–training program during the post-operative period. Both IG and control group (CG) participated in the QoL, functional, and nutritional assessments before exercise training (T0), 2 months after the beginning of the exercise (end of treatment) (T1), and 2 (T2) and 4 (T3) months from the end of treatment. Eleven patients with colorectal cancer that underwent laparoscopic surgery were enrolled (six intervention; five control). The IG showed significant improvements compared to the CG in “Physical functioning” (PF2) (p = 0.030), “Cognitive functioning” (CF) (p = 0.018), and “Fatigue” (FA) (p = 0.017) of the European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) at T1; in SMWT (p = 0.022) at T1; in PF2 (p = 0.018) and FA (p = 0.045) of EORTC QLQ-C30 at T2, in phase angle (PhA) of bioelectrical impedance analysis (p = 0.022) at T3. This pilot study shows that a post-operative, combined, and supervised physical exercise program may have positive effects in improving the QoL, functional capacity, and nutritional status in patients that undergo laparoscopic colorectal cancer surgery.
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Affiliation(s)
- Sveva Maria Nusca
- PhD Course in “Translational Medicine and Oncology”, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy
- Correspondence:
| | - Attilio Parisi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
| | - Marcello Gasparrini
- Department of General Surgery, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
| | - Francesco Antonio Pitasi
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Alessandra Lacopo
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Vincenzo Colonna
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Giulia Stella
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Claudia Cerulli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Elisa Grazioli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Flavia Santoboni
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Eleonora Latini
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Donatella Trischitta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Mario Vetrano
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Vincenzo Visco
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (V.V.); (A.P.)
| | - Antonio Pavan
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (V.V.); (A.P.)
| | - Maria Chiara Vulpiani
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
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Westrich G, Mykoniatis I, Stefan S, Siddiqi N, Ahmed Y, Cross M, Nissan A, Khan JS. Robotic surgery for colorectal cancer in the Octogenarians. Int J Med Robot 2021; 17:e2268. [PMID: 33928752 DOI: 10.1002/rcs.2268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/03/2021] [Accepted: 04/21/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND We evaluated the short-term outcomes of robotic colorectal cancer surgery in octogenarian patients, focussing on postoperative morbidity and survival. METHODS All patients ≥80 years in a prospective colorectal cancer database undergoing robotic curative colorectal cancer resection were included. Patient demographics, intraoperative findings, postoperative and oncological outcomes were recorded. Patients were further subdivided into two groups named: old (OG 80-85 years) and very old (VOG ≥ 86 years). RESULTS Fifty-eight consecutive patients were included (median age, 83 years; male, 53.4%; median BMI, 26.5). Median total operative time was 230 min, median blood loss 20 ml, median length of stay 7 days. Major complications were seen in 12% of patients; and the 90-day mortality rate was 1.7%. Complete R0 resection achieved in 93% of cases, average lymph node harvest was 22. Overall and disease-free survival was 81% and 87.3%, respectively (median follow-up 24.5 months). We noticed a trend towards more advanced lesion staging in the VOG, but only N2 stage was significant (p = 0.03). There was a statistically significant difference in overall survival in favour of the OG (p = 0.024). CONCLUSIONS Robotic surgery is feasible in octogenarian patients undergoing curative colorectal cancer resection and is associated with good post-operative outcomes and overall survival.
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Affiliation(s)
- Gal Westrich
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.,Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Ramat Gan, Israel
| | - Ioannis Mykoniatis
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Samuel Stefan
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Najaf Siddiqi
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.,School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
| | - Yousra Ahmed
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Matthew Cross
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Aviram Nissan
- Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Ramat Gan, Israel
| | - Jim S Khan
- Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.,School of Health and Care Professions, University of Portsmouth, Portsmouth, UK
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Janssen TL, de Vries J, Lodder P, Faes MC, Ho GH, Gobardhan PD, van der Laan L. The effects of elective aortic repair, colorectal cancer surgery and subsequent postoperative delirium on long-term quality of life, cognitive functioning and depressive symptoms in older patients. Aging Ment Health 2021; 25:896-905. [PMID: 32054299 DOI: 10.1080/13607863.2020.1725807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: This study aimed to demonstrate the impact of elective major abdominal surgery and subsequent postoperative delirium on quality of life (QOL; primary outcome), cognitive functioning and depressive symptoms (secondary outcomes) in older surgical patients.Method: A single-centre, longitudinal prospective cohort study was conducted between November 2015 and June 2018, including patients ≥70 years old who underwent surgery for colorectal cancer or an abdominal aortic aneurysm. They were followed-up at discharge and at 6 and 12 months postoperatively until June 2019. QOL was assessed with the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Cognitive functioning was measured with the Mini-Mental State Examination and depressive symptoms with the CES-D 16.Results: In all patients (n = 265), physical and psychological health were significantly lower at discharge compared to baseline (p < 0.001 for both domains). Physical health restored after 6 months, but psychological health remained decreased for the complete study period. Psychological, social and environmental QOL were significantly worse in patients with delirium compared to patients without (p = 0.001, p = 0.006 and p = 0.001 respectively). The cognitive functioning score was significantly lower at baseline in patients with delirium compared to those without (p = 0.006). Patients with delirium had a significantly higher CES-D 16 score compared to those without after 12 months (p = 0.027).Conclusion: Physical and psychological QOL were decreased in the early postoperative period. While physical health was restored after 6 and 12 months, psychological health remained decreased. After 12 months, postoperative delirium resulted in worse psychological, social and environmental QOL and more depressive symptoms. Decreased cognitive functioning may be a risk factor for delirium.
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Affiliation(s)
- Ties L Janssen
- Department of Surgery, Amphia Hospital, Breda, the Netherlands
| | - Jolanda de Vries
- Department of Medical Psychology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Miriam C Faes
- Department of Geriatrics, Amphia Hospital, Breda, the Netherlands
| | - Gwan H Ho
- Department of Surgery, Amphia Hospital, Breda, the Netherlands
| | | | - Lijckle van der Laan
- Department of Surgery, Amphia Hospital, Breda, the Netherlands.,Department of Cardiovascular Science, UZ Leuven, Leuven, Belgium
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47
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McCombie AM, Frampton CM, Frizelle FA. Quality of life preferences in colorectal cancer patients aged 80 and over. ANZ J Surg 2021; 91:1859-1865. [PMID: 33851517 DOI: 10.1111/ans.16739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Management of patients with colorectal cancer (CRC) is about not only survival, but also quality of life (QoL). What patients want is important but is not well researched or understood for elderly patients where it is very relevant. This study aimed to measure and compare what patients with CRC aged 80 and over and surgeons consider important in terms of survivorship after surgery for CRC. METHODS Patients aged 80 and over who were having surgery for CRC were recruited and interviewed using closed and open questions about their expectations of surgery and various QoL dimensions. These were assessed preoperatively and 3 months post-operatively. Surgeons ranked the same QoL dimensions of patients by questionnaire. RESULTS Nineteen patients (median age 87.5, range 80-95, eight males and 11 females) were recruited. Patients rated items relating to health, mobility and independence (n = 23) as top three items most often followed by people outside self (n = 13). Surgeons underestimated importance in 17 domains with the biggest discrepancy being in 'avoiding a stoma' (4.11 versus 2.3, P < 0.01). CONCLUSION With patients over 80 years having surgery for CRC, there is a lack of concordance between what surgeons think is important and what patients think is important. Despite this, CRC patients aged 80 and older are almost always satisfied with the outcome of surgery. Surgeons should ensure that they understand patients' expectations and that they are aligned with likely outcomes of surgery.
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Affiliation(s)
- Andrew M McCombie
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Medicine, The University of Otago, Christchurch, New Zealand
| | - Frank A Frizelle
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
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Borchert K, Jacob C, Wetzel N, Jänicke M, Eggers E, Sauer A, Marschner N, Altevers J, Mittendorf T, Greiner W. Application study of the EQ-5D-5L in oncology: linking self-reported quality of life of patients with advanced or metastatic colorectal cancer to clinical data from a German tumor registry. HEALTH ECONOMICS REVIEW 2020; 10:40. [PMID: 33313984 PMCID: PMC7733616 DOI: 10.1186/s13561-020-00297-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/26/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND The EQ-5D-5L questionnaire is used in oncology to generate health-related quality of life (HRQoL) weights and corresponding health states. The purpose was to explore the relationship between demographic and clinical characteristics and HRQoL among advanced or metastatic colorectal cancer (CRC) patients by linking clinical data of a German CRC registry to self-reported HRQoL measures from the EQ-5D-5L. METHODS The study sample included patients with advanced or metastatic CRC currently recruited in the German Tumor Registry Colorectal Cancer. The EQ-5D-5L was administered once to patients who were at the start or at later stages of palliative treatment. Data on comorbidities, disease-specific health states, symptoms, and treatment status were drawn from the registry. Multivariate regression analyses were performed to explore the impact of patient and disease characteristics on HRQoL. RESULTS In total, n = 433 questionnaires were included in the data analysis. Mean age of patients was 66.3 years and 61.2% were male. The mean EQ-5D-5L utility score was 0.82 and the mean EQ-5D-5L VAS score was 62.05. The regression analyses revealed that none of the demographic characteristics and few of the clinical characteristics, such as fatigue and pain, had a significant impact on the HRQoL. CONCLUSIONS The study demonstrated a reduced HRQoL of patients with advanced or metastatic CRC when compared to the general population. The symptoms fatigue and pain negatively affected the HRQoL, whereas other characteristics such as age, gender, and comorbidities did not have a significant impact on HRQoL.
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Affiliation(s)
| | | | | | | | | | - Annette Sauer
- Medizinisches Versorgungszentrum für Blut- und Krebserkrankungen, Potsdam, Germany
| | - Norbert Marschner
- Praxis für interdisziplinäre Onkologie und Hämatologie, Freiburg im Breisgau, Germany
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Kabiru CM, Karimi PN, Nyamu DG, Weru IW. Drug therapy problems and health related quality of life among patients with colorectal cancer in a Kenyan tertiary health facility. J Oncol Pharm Pract 2020; 27:428-434. [PMID: 33236676 DOI: 10.1177/1078155220971024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer is the third most common form of cancer in males and the second in females globally. The ill-health due to cancer and use of multiple therapies may result in drug related problems and also affect the health-related quality of life of the patients. OBJECTIVE To characterize drug therapy problems and health-related quality of life among patients with colorectal cancer at Kenyatta National Hospital.Methodology: A descriptive prospective cross-sectional study design was used and simple random sampling utilized to select seventy- one participants. The participants were interviewed and their responses captured using World Health Organisation Quality of Life-BREF and a structured questionnaire. The data were analysed using STATA version 15.0. Data was summarized using descriptive statistic such as mean, range and standard deviation. Association between variables was determined using linear regression model at 0.05% level of significance. Ethical approval was granted by the relevant authorities to conduct the study. RESULTS Patients were predominantly females (52.1%), had a mean age of 55.9± 14.4 years. The main drug therapy problems were adverse drug reactions (45.1%). Approximately two thirds (67.6%) of the participants complained of gastrointestinal problems followed by cardiovascular diseases (29.6%). Quality of life assessment indicated that psychological health had the highest score at 60.5%. On linear regression analysis, the presence of anemia (p = 0.021), coverage (p = 0.038), and cardiovascular problems (p = 0.034) were significantly associated with the overall health-related quality of life. CONCLUSION The health-related quality of life was is dependent on several patient related factors. Interventions regarding prevention of drug therapy problems should be considered alongside other measures used to manage colorectal cancer.
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Affiliation(s)
| | - Peter N Karimi
- Department of Pharmaceutics and Pharmacy Practice, The University of Nairobi, Nairobi, Kenya
| | - David G Nyamu
- Department of Pharmaceutics and Pharmacy Practice, The University of Nairobi, Nairobi, Kenya
| | - Irene W Weru
- Pharmacy division, Kenyatta National hospital Nairobi, Kenya
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50
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Mello MRSPD, Moura SF, Muzi CD, GuimarÃes RM. CLINICAL EVALUATION AND PATTERN OF SYMPTOMS IN COLORECTAL CANCER PATIENTS. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:131-136. [PMID: 32401950 DOI: 10.1590/s0004-2803.202000000-24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Colorectal cancer is the third most common type of cancer in the world and the increased survival of the colorectal cancer population is very significant. Thus, it becomes relevant to study the symptoms associated with the progression of the disease and treatment, for proper clinical management. OBJECTIVE To describe the clinical and epidemiological profile of colorectal cancer patients and to identify the most prevalent signs and symptoms patterns. METHODS Cross-sectional study evaluating the prevalence of symptoms in 348 colorectal cancer patients admitted to a referral oncology hospital. We applied MSAS-BR scale and, through factor analysis with principal componente analysys, we performed the grouping of symptoms. RESULTS There was a predominance of men, aged 60 years or older, married, white, with high school, moderately differentiated tumor, stage III/IV disease, colon cancer and no distant metastasis. The most prevalent symptoms were weight loss (67.53%) and the least prevalent were mouth sores (2.01%). The groupings of symptoms established were "fatigue and psychic symptoms", "gastrointestinal symptoms", "self-perceptive symptoms" and "general symptoms", which described 80% of the symptoms presented. CONCLUSION We evidenced the importance of identifying these symptoms clusters in order to improve strategies for clinical management in patients with colorectal cancer.
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Affiliation(s)
| | - Silmara Fernandes Moura
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil
| | - Camila Drumond Muzi
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, RJ, Brasil
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