Baseline Edmonton Symptom Assessment System and Survival in Metastatic Renal Cell Carcinoma

Graham, Jeffrey; Gingerich, Joel Roger; Lambert, Pascal; Alamri, A; Czaykowski, Piotr

doi:10.3747/co.25.3935

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…The median baseline TSDS of our population was 24, which is similar to what has been reported in another group of patients with APC receiving CT [29], and higher than what has been described in many other cancer types [31,32]. For example, in a report of patients with metastatic renal cell carcinoma receiving systemic therapy, the median baseline TSDS was 16 [32], and in a cohort of patients diagnosed with a variety of cancer types, including breast, colorectal, lung, prostate, and hematologic cancers, the mean TSDS at baseline was 22.9 [31]. Most patients (86%) in our cohort had at least one moderate-to-severe physical symptom, and over half of patients had at least one moderate-to-severe psychological symptom at baseline.…”

Section: Discussionsupporting

confidence: 88%

“…In our cohort, both baseline TSDS and the presence of a moderate-to-severe symptom were not associated with shorter survival. In a study of patients with advanced renal cell carcinoma receiving palliative intent therapy, baseline ESAS-r was prognostic [32]. In another study of patients with advanced cancer that did not include APC, both TSDS and the presence of a moderate-to-severe physical symptom, were associated with inferior survival [25].…”

Section: Discussionmentioning

confidence: 99%

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Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

et al. 2021

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Patients with advanced pancreatic cancer (APC) experience many disease-related symptoms. ESAS-r measures the severity of 9 symptom domains and has been validated for use in the ambulatory oncology setting. We aimed to describe symptom burden at baseline for patients with APC treated with modern chemotherapy (CT), and to determine whether symptom burden at baseline is prognostic. Patients diagnosed with APC between 2012–2016, treated with ≥1 cycle of CT, who completed ≥1 ESAS-r were identified. Descriptive statistics were used to report symptom burden and common moderate-to-severe symptoms. A joint model was used to describe the trajectory of ESAS-r during follow-up while controlling for death. Multivariable Cox regression was used to identify independent predictors of death. Of 123 patients identified, the median age was 65 and 61% had metastatic disease. The median baseline ESAS-r total symptom distress score (TSDS) was 24. A total of 86% of patients had at least one symptom score of ≥4 at baseline, with the most common being: fatigue, nausea, anxiety, and shortness of breath. Median overall survival was 10.2 months. Baseline TSDS was not predictive for worse survival in the era of modern CT. Patients with APC have a high burden of cancer-associated symptoms and a high prevalence of moderate-to-severe symptoms. Early intervention has the potential to improve quality of life in this group of patients and should be investigated.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

et al. 2021

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“…Full details of the 11 included cohort studies are contained in Table 2. One was in the context of aggregated RCT data [21] and 10 were original cohorts [22][23][24][25][26][27][28][29][30][31]. The tumour breakdown of these patient cohorts were as follows: five analyses included urological cancer patients [21-23, 27, 28], four colorectal [21,22,30,31], three gynaecological [21,22,26], three pancreatic [24,25,29] and one gastric cancer cohort [31].…”

Section: Cohort Studiesmentioning

confidence: 99%

“…Similarly, an American analysis of 917 prostate cancer patients demonstrated that patient self-rated health is a potential confounder in the relationship between patient satisfaction and survival; thus suggesting that future studies investigating patient satisfaction should include collection of selfrated health modules [27]. In renal cancer, a study by Graham et al observed that baseline use of the Edmonton Symptom Assessment System provides a modest degree of prognostic information about survival, independently of other widely used prognostic models [23]. These results were consistent with previously reported data examining the prognostic function of the FACT-KSI instrument.…”

Section: Cohort Studiesmentioning

confidence: 99%

An assessment of the use of patient reported outcome measurements (PROMs) in cancers of the pelvic abdominal cavity: identifying oncologic benefit and an evidence-practice gap in routine clinical practice

Moss

Aggarwal

Qureshi

et al. 2021

Health Qual Life Outcomes

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Background Patient reported outcome measurements (PROMs) are emerging as an important component of patient management in the cancer setting, providing broad perspectives on patients’ quality of life and experience. The use of PROMs is, however, generally limited to the context of randomised control trials, as healthcare services are challenged to sustain high quality of care whilst facing increasing demand and financial shortfalls. We performed a systematic review of the literature to identify any oncological benefit of using PROMs and investigate the wider impact on patient experience, in cancers of the pelvic abdominal cavity specifically. Methods A systematic review of the literature was conducted using MEDLINE (Pubmed) and Ovid Gateway (Embase and Ovid) until April 2020. Studies investigating the oncological outcomes of PROMs were deemed suitable for inclusion. Results A total of 21 studies were included from 2167 screened articles. Various domains of quality of life (QoL) were identified as potential prognosticators for oncologic outcomes in cancers of the pelvic abdominal cavity, independent of other clinicopathological features of disease: 3 studies identified global QoL as a prognostic factor, 6 studies identified physical and role functioning, and 2 studies highlighted fatigue. In addition to improved outcomes, a number of included studies also reported that the use of PROMs enhanced both patient-clinician communication and patient satisfaction with care in the clinical setting. Conclusions This review highlights the necessity of routine collection of PROMs within the pelvic abdominal cancer setting to improve patient quality of life and outcomes.

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“…The ESAS is a validated standardised patient-centred symptom assessment tool used to evaluate the severity of nine physical and psychological symptoms of distress related to cancer. [4][5][6]8,15,18,20,[23][24][25][27][28][29]31,33,40,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] Cancer Care Ontario implemented the ESAS symptom assessment tool in 2008 to improve patients' symptom management. 15,33,50 The goal of this study is to report on our clinical experience with the ESAS questionnaire responses by patients.…”

Section: Introductionmentioning

confidence: 99%

Systematic self-reporting of patients’ symptoms: improving oncologic care and patients’ satisfaction

et al. 2022

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Background: In recent years, there has been a growing interest to enhance patients’ symptom management during routine cancer care using patient-reported outcome measures. The goal of this study is to analyse patients’ responses to the Edmonton Symptom Assessment System (ESAS) to determine whether patient-reported outcomes could help characterise those patients with the highest supportive care needs and symptom burden in order to help provide targeted support for patients. Methods: In this study, we analysed ESAS questionnaire responses completed by patients as part of their routine care and considered part of patients’ standard of care. Statistical analyses were performed using the IBM SPSS Statistics version 26.0. Descriptive statistics are used to summarise patient demographics, disease characteristics and patient-reported symptom severity and prevalence. Results: The overall mean age is 65.2 ± 12.8 years comprising 43.8% male and 56.2% female patients. The five common primary disease sites are breast (26.2%), haematology (21.1%), gastrointestinal (15.3%), genitourinary (12.7%) and lung (12.0%) cancers. The mean severity for each symptom is all mild (score: 1–3). The three most common reported symptoms causing distress are tiredness, poor overall wellbeing and anxiety, and the least reported symptom is nausea. Conclusions: Systematic self-reporting of patients’ symptoms is important to improve symptom management, timely facilitation of appropriate intervention, patient experience, and patient and family satisfaction. The awareness of disease site, gender and age-related symptom variations should help in the design and provision of appropriate symptom-directed, tumour-specific and patient-focused interventions to meet patients’ immediate needs.

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Baseline Edmonton Symptom Assessment System and Survival in Metastatic Renal Cell Carcinoma

Abstract: Background Baseline symptom burden as measured using the Edmonton Symptom Assessment System (esas),

Cited by 9 publications

References 13 publications

Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

An assessment of the use of patient reported outcome measurements (PROMs) in cancers of the pelvic abdominal cavity: identifying oncologic benefit and an evidence-practice gap in routine clinical practice

Systematic self-reporting of patients’ symptoms: improving oncologic care and patients’ satisfaction

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