Repository logo
 
Publication

Symptom Clusters in Patients With Advanced Cancer: a Prospective Longitudinal Cohort Study to Examine Their Stability and Prognostic Significance

dc.contributor.authorSimão, D
dc.contributor.authorBarata, P
dc.contributor.authorAlves, M
dc.contributor.authorPapoila, AL
dc.contributor.authorOliveira, S
dc.contributor.authorLawlor, P
dc.date.accessioned2024-08-28T13:56:47Z
dc.date.available2024-08-28T13:56:47Z
dc.date.issued2024
dc.description.abstractThis 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.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationOncologist . 2024 Jan 5;29(1):e152-e163.pt_PT
dc.identifier.doi10.1093/oncolo/oyad211pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/5012
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxfordpt_PT
dc.subjectHSAC ONCpt_PT
dc.subjectHDE CINVpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectHumanspt_PT
dc.subjectAdultpt_PT
dc.subjectLongitudinal Studiespt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectDisease Progressionpt_PT
dc.subjectPrognosispt_PT
dc.subjectNeoplasms* / therapypt_PT
dc.subjectProspective Studiespt_PT
dc.subjectPalliative Carept_PT
dc.subjectSyndromept_PT
dc.titleSymptom Clusters in Patients With Advanced Cancer: a Prospective Longitudinal Cohort Study to Examine Their Stability and Prognostic Significancept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee163pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPagee152pt_PT
oaire.citation.titleThe Oncologistpt_PT
oaire.citation.volume29pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Oncologist.pdf
Size:
2.39 MB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: