1510 Clinical implications of C-reactive protein as a prognostic marker in advanced cancer patients in palliative settings

Amano, K.; Maeda, Isseki; Morita, Teruo; Miura, Toshio; Inoue, Satoshi; Ikenaga, Masahiro; Matsumoto, Yōko; Baba, Mika; Sekine, Ryuichi; Yamaguchi, Takahiro; Hirohashi, Takeshi; Tajima, Takayuki; Tatara, Ryohei; Watanabe, Hideaki; Otani, Hiroshi; Takigawa, Chizuko; Matsuda, Yoshinari; Nagaoka, Hiroto; Mori, Masahiro; Kinoshita, Hidechika

doi:10.1016/s0959-8049(16)30600-1

Cited by 6 publications

(13 citation statements)

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“…Advanced cancer patients generally receive systemic anticancer treatment until a late stage in their disease trajectory and the interaction of it with CRP level and the development of cachexia is unknown . Fifth, we classified the patients into four groups using approximate figures to quartile points of CRP values as our previous study, which indicated that CRP could be useful in predicting prognoses in advanced cancer patients . We believe the validity of our method, because these cut‐off values are statistically and clinically relevant.…”

Section: Discussionmentioning

confidence: 91%

“…Participants were divided into four groups: (i) low (CRP < 1 mg/dl), (ii) moderate (1 = < CRP <5 mg/dl), (iii) high (5 = < CRP < 10 mg/dl), and (iv) very high CRP (10 mg/dl = < CRP). We used approximate figures to quartile points as our previous study, which indicated that CRP could be useful in predicting prognoses in advanced cancer patients.…”

Section: Methodsmentioning

confidence: 99%

“…The level of C‐reactive protein (CRP) has been reported to be a good prognostic marker in advanced cancer patients . It is elevated in advanced cancer patients as well as in those with chronic inflammatory disease and has been shown to be related to an increased cancer risk, anorexia, weight loss, fatigue, and pain in cancer patients …”

Section: Introductionmentioning

confidence: 99%

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C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care

Amano

Maeda

Morita

et al. 2017

J cachexia sarcopenia muscle

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BackgroundThe association between C‐reactive protein (CRP) level, symptoms, and activities of daily living (ADL) in advanced cancer patients is unclear.MethodsSecondary data analysis of a multicenter prospective cohort study consisted of 2426 advanced cancer patients referred to palliative care settings was conducted to examine the cross‐sectional relationships between CRP level, symptoms, and ADL disabilities. Laboratory data, symptoms, ADL, and manual muscle testing (MMT) results were obtained at baseline. Participants were divided into four groups: low (CRP < 1 mg/dl), moderate (1 = < CRP <5 mg/dl), high (5 = < CRP < 10 mg/dl), and very high CRP (10 mg/dl = < CRP). The proportions of eight symptoms, five ADL disabilities, and three categories of MMT according to the CRP groups were tested by chi‐square tests. Multiple‐adjusted odd ratios (ORs) were calculated by using ordinal logistic regression after adjustment for age, gender, site of primary cancer, metastatic disease, performance status, chemotherapy, and setting of care.ResultsA total of 1702 patients were analysed. Positive rates of symptoms and ADL disabilities increased with increasing CRP level. In the very high‐CRP group, rates of positivity for anorexia, fatigue, and weight loss were 89.8%, 81.0%, and 79.2%, respectively, and over 70% of patients received assistance for bathing, dressing, going to the toilet, and transfer. The grade of MMT also deteriorated with increasing CRP level. Adjusted ORs for the accumulated symptoms significantly increased with increasing CRP level in the moderate‐CRP, high‐CRP, and very high‐CRP groups [1.6 (95% confidence interval 1.2–2.0), P < 0.001; 2.5 (1.9–3.2), P < 0.001; 3.5 (2.7–4.6), P < 0.001, respectively]. Adjusted ORs for the accumulated ADL disabilities significantly increased in the very high‐CRP groups [2.1 (1.5–2.9), P < 0.001].ConclusionsAssociations between CRP level, symptoms, and ADL were observed in advanced cancer patients receiving palliative care.

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Section: Discussionmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

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C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care

Amano

Maeda

Morita

et al. 2017

J cachexia sarcopenia muscle

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“…Subjects were also divided into four groups according to CRP levels: (i) low (CRP < 1 mg/dl), (ii) moderate (1 ≤ CRP < 5 mg/dl), (iii) high (5 ≤ CRP < 10 mg/dl), and (iv) very high (10 mg/dl ≤ CRP). We used approximate figures to quartile points, as described in our previous studies, 10,11 which indicated that CRP may be useful for predicting outcomes, symptoms, and activities of daily living disabilities in patients with advanced cancer. We assessed the associations between CRP levels and proportions of psychological symptoms, including delirium, drowsiness, sleep disturbance, anxiety, and depression.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…sleep disturbance, depression, and cognitive dysfunction, as well as physical disorders in patients with cancer. [7][8][9][10][11][12][13][14][15][16] Nevertheless, studies on CNS regulation in cancer cachexia have been limited to investigations on the systemic levels of neuromodulatory peptides, such as appetite-regulating hormones. 2 Moreover, 'sickness behaviour' has been reported in infected mammals and recognized as a symptom cluster, including fatigue, sleep disturbance, depression, and cognitive dysfunction, which is associated with systemic inflammation and its impact on the CNS.…”

Section: Introductionmentioning

confidence: 99%

C‐reactive protein, delirium, and other psychological symptoms among patients with advanced cancer

Amano¹,

Hatano

Matsuda

et al. 2020

JCSM Clinical Reports

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BackgroundIt remains unclear whether a relationship exists between elevated C‐reactive protein (CRP) levels and delirium. The primary aim was to investigate the relationship between CRP and delirium in advanced cancer.MethodsThis study was a multicenter prospective cohort study conducted in palliative care units. At baseline, the physicians diagnosed delirium. On the seventh day, they evaluated whether new delirium had occurred. Subjects were divided into four groups according to CRP levels. We assessed the associations between CRP levels and proportions of delirium. To evaluate the relationship between CRP and delirium, adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were calculated in the logistic models.ResultsAmong 1896 patients, 1354 patients were eligible for analyses. We classified them into four groups: low (CRP < 1 mg/dl) (n = 170), moderate (1 ≤ CRP < 5 mg/dl) (n = 453), high (5 ≤ CRP < 10 mg/dl) (n = 334), and very high (10 mg/dl ≤ CRP) (n = 397). The incidence of delirium significantly increased with increasing CRP levels (P = 0.02). In model 1, significantly higher adjusted ORs than in the low CRP group were observed in the high CRP and very high CRP groups (1.63 [95% CI 1.06–2.50], P = 0.03; 1.72 [95% CI 1.13–2.62], P = 0.01, respectively). In model 2, a significantly higher adjusted OR than in the low CRP group was observed in the very high CRP group (1.61 [95% CI 1.05–2.45], P = 0.03).ConclusionsRelationships existed between elevated CRP levels and delirium.

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Integration of palliative, supportive, and nutritional care to alleviate eating-related distress among advanced cancer patients with cachexia and their family members

Amano

Baracos

Hopkinson

2019

Critical Reviews in Oncology/Hematology

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Advanced cancer patients with cachexia and their families can suffer from eating-related distress. This complex entity encompasses patients' struggle to nourish themselves, emotional and social consequences of their inability to maintain food intake, and profound disturbance in family relationships. With evidencebased nutritional care, as well as symptom management to enable food intake, cachexia can be mitigated to some degree. In addition, patients and families require psychosocial support and education to understand and cope with this condition. Only by taking an integrated approach can health care teams alleviate eatingrelated distress, improve quality of life (QOL), reduce interpersonal conflicts, and alter perceptions of nutritional neglect for patients and families. However, few studies have investigated eating-related distress among patients and families. The aim of this narrative review is to describe what is known about eating-related distress and the roles of integrated palliative, supportive, and nutritional care in improving QOL of patients and families.

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1510 Clinical implications of C-reactive protein as a prognostic marker in advanced cancer patients in palliative settings

Cited by 6 publications

References 0 publications

C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care

C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care

C‐reactive protein, delirium, and other psychological symptoms among patients with advanced cancer

Integration of palliative, supportive, and nutritional care to alleviate eating-related distress among advanced cancer patients with cachexia and their family members

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