Cancer symptom burden negatively affects health-related quality of life in patients undergoing prehabilitation prior to liver resection: results from a 12-week randomized controlled trial.
| Autor: | Kasvis, Popi, Vigano, Antonio, Bui, Tram, Carli, Franco, Kilgour, Robert D. |
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| Předmět: |
CANCER patient psychology
GRIP strength BODY composition LIVER tumors ACADEMIC medical centers SPECIALTY hospitals NUTRITIONAL assessment PREOPERATIVE period MULTIVARIATE analysis MULTIPLE regression analysis SURGERY PATIENTS TREATMENT effectiveness CANCER treatment PSYCHOLOGICAL tests FUNCTIONAL assessment QUALITY of life POSTOPERATIVE period RESEARCH funding DESCRIPTIVE statistics QUESTIONNAIRES CANCER fatigue MENTAL depression WALKING PREHABILITATION ANXIETY SYMPTOM burden HEPATECTOMY SECONDARY analysis EXERCISE therapy SYMPTOMS |
| Zdroj: | Applied Physiology, Nutrition & Metabolism; Jan2024, Vol. 49 Issue 1, p64-76, 13p |
| Abstrakt: | This study aimed to (i) explore determinants of health-related quality of life (HRQoL) in patients with cancer awaiting liver resection and entering a prehabilitation program, and (ii) examine the effect of prehabilitation on HRQoL in both the pre- and postoperative period. We randomized patients to prehabilitation or rehabilitation. Prehabilitation began an exercise, nutrition, and relaxation intervention 4 weeks preoperatively; rehabilitation began the same intervention postoperatively. We measured the following at baseline, preoperatively, 4 weeks and 8 weeks postoperatively: HRQoL [Functional Assessment of Cancer Therapy-General (FACT-G)], nutritional status [abridged Patient-Generated Subjective Global Assessment (aPG-SGA)], cancer symptom burden [revised Edmonton Symptom Assessment System (ESAS-r)], fatigue [Brief Fatigue Inventory (BFI)] and anxiety/depression [Hospital Anxiety and Depression Scale (HADS)], 6 min walking distance, handgrip strength, and body composition. At baseline (n = 35, prehabilitation = 17), there were significant negative associations between FACT-G and ESAS-r total score (r = −0.675, p < 0.001), HADS depression (r = −0.618, p < 0.001), BFI (r = −0.612, p < 0.001), aPG-SGA (r = −0.432, p < 0.05), and HADS anxiety (r = −0.397, p < 0.05). There were no associations between FACT-G and strength/function tests or body composition. Robust multivariate regression analysis revealed ESAS-r was the only variable to consistently remain significant and predictive of baseline FACT-G (β = −0.67 to −0.83, p < 0.05, R2 = 36%–41%). There were no differences in FACT-G within or between groups at any timepoint. Cancer symptom burden was predictive of poor HRQoL in patients entering a prehabilitation program prior to liver resection. Future prehabilitation studies in this patient population should test whether the addition of supportive care measures to relieve cancer-related symptoms will lead to significant improvements in HRQoL. Clinicaltrials.gov registration NCT03475966. Cancer symptoms negatively affect health-related quality of life (HRQoL) in patients with cancer awaiting liver resection. Prehabilitation maintained HRQoL after surgery. Future studies should test whether relieving cancer symptoms can improve HRQoL. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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