Preoperative inflammatory biomarkers and neurovegetative symptoms in peritoneal carcinomatosis patients |
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| Affiliation: | 1. Lahey Clinic, Burlington, Massachusetts;2. Icahn School of Medicine at Mount Sinai, New York, New York;3. Rho Federal Systems Division, Inc., Chapel Hill, North Carolina;4. Washington University School of Medicine, St Louis, Missouri;6. Boston University Medical Center, Boston, Massachusetts;5. Columbia University College of Physicians and Surgeons, New York, New York;7. University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;1. University of Michigan, Ann Arbor, Michigan;2. Emory University Department of Urology, Atlanta, Georgia;3. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;4. Dana-Farber Cancer Institute, Boston, Massachusetts;5. Cedars-Sinai Medical Center, Los Angeles, California;7. Massachusetts General Hospital, Boston, Massachusetts;11. Cleveland Clinic, Cleveland, Ohio;12. 21st Century Oncology, Fort Myers, Florida;8. 21st Century Oncology, Scottsdale, Arizona;9. Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; and CIBER en Epidemiología y Salud Pública, Spain;1. Division of Cardiovascular Surgery, Children’s National Health System, Washington, DC;2. The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington, DC;3. Departments of Anesthesia and Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts;4. Departments of Critical Care Medicine and Cardiology, Children’s National Health System, Washington, DC;1. Department of Plastic Surgery, St James''s Hospital Dublin, Trinity College Dublin, Ireland;2. Department of Surgery, St James''s Hospital Dublin, Trinity College Dublin, Ireland;1. School of Health Sciences, Nursing Science, University of Tampere, FI-33014, Finland;2. Pirkanmaa Hospital District, Science Center, Finland;3. Cancer Society of Finland, Unioninkatu 22, 00130 Helsinki, Finland;1. Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China;2. Peking Union Medical College Hospital, Beijing, China;3. Northwestern University Feinberg School of Medicine, Evanston, United States;4. Qiqihar Medical University, Heilongjiang Province, China;5. Medical Psychological Institute of the Second Xiangya Hospital of Central South University, Hunan Province, China;6. The First Special Hospital of Harbin, Heilongjiang Province, China |
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| Abstract: | BackgroundInflammation plays a central role in peritoneal carcinomatosis (PC) etiology and progression, and circulating levels of inflammatory biomarkers prior to surgery predict progression-free and overall survival in PC patients. Depression and fatigue are prevalent among PC patients, and experimental research shows that these symptoms may be mediated by proinflammatory cytokines. As yet unstudied is the possibility that the heightened levels of inflammatory markers in PC patients may contribute to their experience of common neurovegetative symptoms.MethodsValidated self-report measures of fatigue, depressive symptoms, and quality of life were administered to 64 patients scheduled to undergo aggressive surgical treatment for PC. Serum samples were collected the morning of surgery, and ELISAs were conducted to quantify circulating IL-6, CRP, and TNF-α levels.ResultsConsistent with hypotheses, higher IL-6 levels were associated with more severe fatigue (β = −.39, p < .01) and neurovegetative symptoms of depression (β = .30, p < .05). IL-6 was also related to poorer physical quality of life (β = −.28, p < .05). CRP showed similar significant relationships with fatigue and physical quality of life. Inflammatory biomarkers were not significantly related to emotional symptoms of depression or to emotional or social functioning aspects of quality of life, and TNF-α levels were not related to patient-reported measures.ConclusionPreoperative inflammatory activity may contribute to patients’ experiences of fatigue and neurovegetative depressive symptoms as well as impaired quality of life. These biological mechanisms warrant consideration in the clinical management of neurovegetative symptoms in PC patients. |
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| Keywords: | Sickness behavior Inflammation Cytokines Depression Fatigue Neurovegetative symptoms Quality of life Cancer Peritoneal carcinomatosis |
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