41 research outputs found
Cancer patient satisfaction with health care professional communication: An international EORTC study
Diagnostic criteria for cancer cachexia: Reduced food intake and inflammation predict weight loss and survival in an international, multi-cohort analysis
Abstract Background Cancerâassociated weight loss (WL) associates with increased mortality. International consensus suggests that WL is driven by a variable combination of reduced food intake and/or altered metabolism, the latter often represented by the inflammatory biomarker Câreactive protein (CRP). We aggregated data from Canadian and European research studies to evaluate the associations of reduced food intake and CRP with cancerâassociated WL (primary endpoint) and overall survival (OS, secondary endpoint). Methods The data set included a total of 12,253 patients at risk for cancerâassociated WL. Patientâreported WL history (% in 6 months) and food intake (normal, moderately, or severely reduced) were measured in all patients; CRP (mg/L) and OS were measured in N = 4960 and N = 9952 patients, respectively. All measures were from a baseline assessment. Clinical variables potentially associated with WL and overall survival (OS) including age, sex, cancer diagnosis, disease stage, and performance status were evaluated using multinomial logistic regression MLR and Cox proportional hazards models, respectively. Results Patients had a mean weight change of â7.3% (±7.1), which was categorized as: ±2.4% (stable weight; 30.4%), 2.5â5.9% (19.7%), 6.0â10.0% (23.2%), 11.0â14.9% (12.0%), â„15.0% (14.6%). Normal food intake, moderately, and severely reduced food intake occurred in 37.9%, 42.8%, and 19.4%, respectively. In MLR, severe WL (â„15%) (vs. stable weight) was more likely (P  100 mg/L: OR 2.30 (95% CI 1.62â3.26)]. Diagnosis, stage, and performance status, but not age or sex, were significantly associated with WL. Median OS was 9.9 months (95% CI 9.5â10.3), with median followâup of 39.7 months (95% CI 38.8â40.6). Moderately and severely reduced food intake and CRP independently predicted OS (P < 0.0001). Conclusions Modelling WL as the dependent variable is an approach that can help to identify clinical features and biomarkers associated with WL. Here, we identify criterion values for food intake impairment and CRP that may improve the diagnosis and classification of cancerâassociated cachexia
Cancer Appetite and Symptom Questionnaire (CASQ) for Brazilian Patients: Cross-Cultural Adaptation and Validation Study
Background
Appetite and symptoms, conditions generally reported by the patients with cancer, are
somewhat challenging for professionals to measure directly in clinical routine (latent conditions).
Therefore, specific instruments are required for this purpose. This study aimed to perform
a cultural adaptation of the Cancer Appetite and Symptom Questionnaire (CASQ), into
Portuguese and evaluate its psychometric properties on a sample of Brazilian cancer
patients.
Methods
This is a validation study with Brazilian cancer patients. The face, content, and construct
(factorial and convergent) validities of the Cancer Appetite and Symptom Questionnaire,
the study tool, were estimated. Further, a confirmatory factor analysis (CFA) was conducted.
The ratio of chi-square and degrees of freedom (Ï2
/df), comparative fit index (CFI),
goodness of fit index (GFI) and root mean square error of approximation (RMSEA) were
used for fit model assessment. In addition, the reliability of the instrument was estimated
using the composite reliability (CR) and Cronbachâs alpha coefficient (α), and the invariance
of the model in independent samples was estimated by a multigroup analysis (ÎÏ2).
Results
Participants included 1,140 cancer patients with a mean age of 53.95 (SD = 13.25) years;
61.3% were women. After the CFA of the original CASQ structure, 2 items with inadequate
factor weights were removed. Four correlations between errors were included to provide
adequate fit to the sample (Ï2
/df = 8.532, CFI = .94, GFI = .95, and RMSEA = .08). Themodel exhibited a low convergent validity (AVE = .32). The reliability was adequate
(CR = .82 α = .82). The refined model showed strong invariance in two independent samples
(ÎÏ2
: λ: p = .855; i: p = .824; Res: p = .390). A weak stability was obtained between
patients undergoing chemotherapy and radiotherapy (ÎÏ2
: λ: p = .155; i: p < .001; Res:
p < .001), and between patients undergoing chemotherapy combined with radiotherapy
and palliative care (ÎÏ2
: λ: p = .058; i: p < .001; Res: p < .001).
Conclusion
The Portuguese version of the CASQ had good face and construct validity and reliability.
However, the CASQ still presented invariance in independent samples of Brazilian patients
with cancer. However, the tool has low convergent validity and weak invariance in samples
with different treatment
Factors associated with malnutrition in hospitalized cancer patients: a croos-sectional study
The ESPEN anorexia score is a reliable tool to quantitatively and qualitatively assess appetite in unselected cancer patients.
Combating HER2-overexpressing breast cancer through induction of calreticulin exposure by Tras-Permut CrossMab
Beyond anorexia -cachexia. Nutrition and modulation of cancer patients' metabolism: Supplementary, complementary or alternative anti-neoplastic therapy?
Anorexia and muscle wasting are frequently observed in cancer patients and influence their clinical outcome. The better understanding of the mechanisms underlying behavioral changes and altered metabolism yielded to the development of specialized nutritional support, which enhances utilization of provided calories and proteins by counteracting some of the metabolic derangements occurring during tumor growth. Inflammation appears to be a key factor determining the cancer-associated biochemical abnormalities eventually leading to anorexia and cachexia. Interestingly, inflammation is also involved in carcinogenesis, cancer progression and metastasis by impairing immune surveillance, among other mechanisms. Therefore, nutritional interventions aiming at modulating inflammation to restore nutritional status may also result in improved response to pharmacological anti-cancer therapies. Recent clinical data show that supplementation with nutrients targeting inflammation and immune system increases response rate and survival in cancer patients. This suggests that nutrition therapy should be considered as an important adjuvant strategy in the multidimensional approach to cancer patients. (C) 2011 Elsevier B.V. All rights reserved