Publication
Symptom Clusters in Patients With Advanced Cancer: a Prospective Longitudinal Cohort Study to Examine Their Stability and Prognostic Significance
| dc.contributor.author | Simão, D | |
| dc.contributor.author | Barata, P | |
| dc.contributor.author | Alves, M | |
| dc.contributor.author | Papoila, AL | |
| dc.contributor.author | Oliveira, S | |
| dc.contributor.author | Lawlor, P | |
| dc.date.accessioned | 2024-08-28T13:56:47Z | |
| dc.date.available | 2024-08-28T13:56:47Z | |
| dc.date.issued | 2024 | |
| dc.description.abstract | This study's purpose was to assess symptom cluster (SC) stability during disease progression and determine their strength of association with survival in patients with advanced cancer . Consecutively eligible patients with advanced cancer not receiving cancer-specific treatment and referred to a Tertiary Palliative Care Clinic were enrolled in a prospective cohort study. At first consultation (D0) and in subsequent consultations at day 15 (D15) and day 30 (D30), patients rated 9 symptoms through the Edmonton Symptom Assessment System scale (0-10) and 10 others using a Likert scale (1-5). Principal components factor analysis with varimax rotation was used to determine SCs at each consultation. Of 318 patients with advanced cancer, 301 met eligibility criteria with a median age of 69 years (range 37-94). Three SCs were identified: neuro-psycho-metabolic (NPM), gastrointestinal, and sleep impairment, with some variations in their constitution over time. Exploratory factor analysis accounted for 40% of variance of observed variables in all SCs. Shorter median survival was observed continuously for NPM cluster (D0 23 vs. 58 days, P < .001; D15 41 vs. 104 days, P=.004; D30 46 vs. 114 days, P = .002), although the presence of 2 or more SCs on D0 and D15 also had prognostic significance (D0: 21 vs. 45 days, P = .005; D30: 50 vs. 96 days, P = .040). In a multivariable model, NPM cluster (D0 hazard ratio estimate: HR 1.64; 95%CI, 1.17-2.31; P = .005; D15 HR: 2.51; 95%CI, 1.25-5.05; P = .009; D30 HR: 3.9; 95%CI, 1.54-9.86; P = .004) and hospitalization (D0 HR: 2.27; 95%CI, 1.47-3.51; P < .001; D15 HR: 2.43; 95%CI, 1.18-5.01; P = .016; D30 HR: 3.41; 95%CI, 1.35-8.62; P = .009) were independently and significantly associated with worse survival. Three clinically relevant SCs were identified, and their constitution had small variations, maintaining a stable set of nuclear symptoms through disease progression. Presence of the NPM cluster and hospitalization maintained their prognostic value over time. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Oncologist . 2024 Jan 5;29(1):e152-e163. | pt_PT |
| dc.identifier.doi | 10.1093/oncolo/oyad211 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/5012 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Oxford | pt_PT |
| dc.subject | HSAC ONC | pt_PT |
| dc.subject | HDE CINV | pt_PT |
| dc.subject | Aged | pt_PT |
| dc.subject | Aged, 80 and over | pt_PT |
| dc.subject | Humans | pt_PT |
| dc.subject | Adult | pt_PT |
| dc.subject | Longitudinal Studies | pt_PT |
| dc.subject | Middle Aged | pt_PT |
| dc.subject | Disease Progression | pt_PT |
| dc.subject | Prognosis | pt_PT |
| dc.subject | Neoplasms* / therapy | pt_PT |
| dc.subject | Prospective Studies | pt_PT |
| dc.subject | Palliative Care | pt_PT |
| dc.subject | Syndrome | pt_PT |
| dc.title | Symptom Clusters in Patients With Advanced Cancer: a Prospective Longitudinal Cohort Study to Examine Their Stability and Prognostic Significance | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | e163 | pt_PT |
| oaire.citation.issue | 1 | pt_PT |
| oaire.citation.startPage | e152 | pt_PT |
| oaire.citation.title | The Oncologist | pt_PT |
| oaire.citation.volume | 29 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |