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Association of health literacy with cancer survival: a single-centre prospective cohort study.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-04-02 DOI: 10.2340/1651-226X.2025.42557
Niclas Sandström, Antti Jekunen, Mikael Johansson, Heidi Andersén
{"title":"Association of health literacy with cancer survival: a single-centre prospective cohort study.","authors":"Niclas Sandström, Antti Jekunen, Mikael Johansson, Heidi Andersén","doi":"10.2340/1651-226X.2025.42557","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42557","url":null,"abstract":"<p><strong>Background and purpose: </strong>Health literacy is defined as the ability to find, understand and use health information for informed decision. The role of health literacy in treatment decisions and outcome remains largely unexplored. This study sought out to assess the effect of individual health literacy on overall survival (OS) in cancer patients in Ostrobothnia.</p><p><strong>Material and methods: </strong>The present study is a follow-up of a cross-sectional survey study performed during December 2021 and March 2022. The survey assessed socioeconomic factors, lifestyle factors and self-reported health literacy. The follow-up included data on recorded death, cause of death, performance status (PS), clinical frailty scale, Charlson comorbidity index and body mass index. The sample size for this study was 400 participants, and any participant with a malignancy was eligible for the study.</p><p><strong>Results: </strong>Low health literacy was associated with increased risk of death. The disparity remained after adjustments for age, sex, comorbidities, PS, stage and hazard ratios (HR) = 1.47 (1.01-2.14). After adjustments for lifestyle patterns, the disparity remained, HR = 1.49 (1.03-2.17). The difference diminished after adjustments for cancer types. The median OS was 3.6 months longer for those with medium-high health literacy than those with low health literacy.</p><p><strong>Interpretation: </strong>The results indicated health literacy having a direct, clinically significant, effect on OS, which is likely not explained by differences in cancer entity alone. Future studies should focus on assessing whether an intervention aiming to improve health literacy may improve overall cancer survival.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"499-506"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of exercise in patients with lower limb lymphedema: a systematic review.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-31 DOI: 10.2340/1651-226X.2025.42560
Merete Celano Wittenkamp, Jan Christensen, Anders Vinther, Carsten Bogh Juhl
{"title":"The effect of exercise in patients with lower limb lymphedema: a systematic review.","authors":"Merete Celano Wittenkamp, Jan Christensen, Anders Vinther, Carsten Bogh Juhl","doi":"10.2340/1651-226X.2025.42560","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42560","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize the evidence of the immediate and long-term effect of exercise interventions in patients with either primary or secondary lower limb lymphedema (LLL) on health-related quality of life (HR-QOL), physical function, self-reported symptoms, lower limb volume, and adverse events.</p><p><strong>Design: </strong>Systematic review following the guidelines from the Cochrane Handbook of Systematic Reviews of Interventions.</p><p><strong>Data sources: </strong>MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrials.gov.</p><p><strong>Eligibility criteria: </strong>Prospective exercise trials investigating exercise interventions as a single- or multicomponent programme in patients with LLL including assessment of at least one of the following outcomes: HR-QOL, self-reported LLL symptoms (heaviness, tension, and pain), physical function, or lower limb volume. Randomized controlled trials (RCTs), single-group studies, and cross-over trials were eligible. Trials with participants at risk of LLL or a diagnosis of filariasis or lipedema were excluded.</p><p><strong>Results: </strong>Twelve studies were included: three RCTs, five single-group studies, and four cross-over trials with a total of three hundred and sixty-seven participants. In patients with LLL, irrespective of severity, exercise seemed to have small but positive effects on HR-QOL, physical function, pain, and lower limb volume. Quality assessment showed high risk of bias. Large heterogeneity in participants, interventions, and outcome measures hinders performing of meta-analyses.</p><p><strong>Interpretation: </strong>Based on a small number of studies with large clinical heterogeneity, poor methodological quality, hence low level of certainty of evidence, it was not possible to provide evidence-based recommendations on exercise for patients with LLL.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"484-498"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survivor-driven development of a PROM for use in routine colorectal cancer care.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-27 DOI: 10.2340/1651-226X.2025.42032
Johanne D Lyhne, Lise Gade, Laila Hansen, Anne Johansen, Allan 'Ben' Smith, Lars Henrik Jensen, Lise Ventzel
{"title":"Survivor-driven development of a PROM for use in routine colorectal cancer care.","authors":"Johanne D Lyhne, Lise Gade, Laila Hansen, Anne Johansen, Allan 'Ben' Smith, Lars Henrik Jensen, Lise Ventzel","doi":"10.2340/1651-226X.2025.42032","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42032","url":null,"abstract":"<p><strong>Background and purpose: </strong>Despite the availability of patient reported outcome (PRO) measures (PROMs) for assessing survivorship care needs, their successful implementation remains limited. This study aimed to improve the likelihood of implementation success by actively engaging end-users in developing a PROM designed to address implementation barriers.</p><p><strong>Patients and methods: </strong>Selected barriers for implementation were: (1) PROMs do not adequately address relevant issues, (2) PROMs can inhibit patient-clinician interaction, and (3) PROMs are not suitable for all patients. Management of these barriers were discussed at two 1-day workshops at Vejle Hospital with in-person attendance by colorectal cancer (CRC) survivors and informal caregivers (ICs). Relevant issues of CRC survivorship care (barrier 1) were defined based on data from four distinct sources. Solutions to overcoming barriers 2 and 3 were discussed at the workshops. Workshop data were guided by the Qualitative Analysis Guide of Leuven (QUAGOL) guide.</p><p><strong>Results: </strong>The four distinct sources provided data from 4,545 CRC survivors. Thirteen individuals attended the in-person workshops. The following constructs were identified as relevant (barrier 1): self-rated well-being relative to pre-diagnosis, late effects encompassing both psychological and physical aspects, the role of caregivers, identity considerations, support systems, economic impacts, rehabilitation needs, and information provision. Specific element (e.g., keywords, prioritisation and agenda-setting) were incorporated to facilitate patient-clinician interactions (barrier 2). All constructs were considered relevant across all stages of CRC survivorship (barrier 3). The final PROM comprised 34 items.</p><p><strong>Interpretation: </strong>This dialogue-tool is designed to address implementation barriers by providing direct feedback on relevant late effects and supportive care needs from CRC survivors to clinicians.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"475-483"},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment group-specific inferences in Phase III Randomized Oncology Trials.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-24 DOI: 10.2340/1651-226X.2025.42663
Alexander D Sherry, Adina H Passy, Joseph Abi Jaoude, Timothy A Lin, Ramez Kouzy, Pavlos Msaouel, Ethan B Ludmir
{"title":"Treatment group-specific inferences in Phase III Randomized Oncology Trials.","authors":"Alexander D Sherry, Adina H Passy, Joseph Abi Jaoude, Timothy A Lin, Ramez Kouzy, Pavlos Msaouel, Ethan B Ludmir","doi":"10.2340/1651-226X.2025.42663","DOIUrl":"10.2340/1651-226X.2025.42663","url":null,"abstract":"<p><strong>Background: </strong>Estimation of comparative treatment effects between randomized groups is well-supported in randomized trials. By contrast, treatment group-specific inferences are challenging, as patients are selectively chosen for enrollment, and such inferences are formally discouraged by the CONSORT guidelines. The present study is the first-large scale assessment of the proportion of phase III oncology trials that present treatment group-specific inferences.</p><p><strong>Methods: </strong>Published phase III randomized oncology trials were screened from ClinicalTrials.gov. Treatment group-specific inferences were defined by the presence of 95% CI or standard error for treatment-specific outcomes.</p><p><strong>Results: </strong>A total of 774 phase III trials enrolling 568,080 patients were included. Treatment group-specific inferences were present in 58% of trials (446 of 774), and appeared to be increasing over time (adjusted odds ratio for the publication year, 1.11; 95% CI, 1.06 to 1.17; p < 0.0001). Of the remaining 328 trials, 49 (6%) described group-specific outcomes with measures of variability, such as interquartile range, and 279 (36%) provided point estimates only (e.g., median) for group outcomes.</p><p><strong>Interpretation: </strong>The majority of published phase III oncology trials present treatment group-specific inferences. However, this inference lacks statistical support, as patients are not randomly sampled from the underlying population, and conflicts with CONSORT guidelines. While ongoing methodological efforts to improve the transportability of treatment group-specific inferences are promising, conventional attempts to generalize treatment-specific outcomes from randomized trials may be misleading. Instead of inference, treatment group-specific outcomes should be described using measures of variability.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"470-474"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment decision-making and treatment experiences in men with metastatic castration-resistant prostate cancer.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-24 DOI: 10.2340/1651-226X.2025.42748
Sandra Doveson, Per Fransson, Lena Axelsson, Agneta Wennman-Larsen
{"title":"Treatment decision-making and treatment experiences in men with metastatic castration-resistant prostate cancer.","authors":"Sandra Doveson, Per Fransson, Lena Axelsson, Agneta Wennman-Larsen","doi":"10.2340/1651-226X.2025.42748","DOIUrl":"10.2340/1651-226X.2025.42748","url":null,"abstract":"<p><strong>Background and purpose: </strong>For the most advanced stage of metastatic castration-resistant prostate cancer (mCRPC), several life-prolonging treatments have become available over the past decade. Treatment decision-making (TDM) and experiences in this phase are yet to be studied. Hence, this study aimed to describe men's satisfaction with TDM and treatment experiences during the first 12 months of a life-prolonging treatment of mCRPC.</p><p><strong>Patients and methods: </strong>This prospective study included 104 men with mCRPC who started and remained on the same life-prolonging treatment for 12 months. They received a questionnaire on TDM, treatment experiences, and well-being every 3 months. Correlation analyses explored associations between satisfaction with TDM at baseline and treatment experiences and well-being over time.</p><p><strong>Results and interpretation: </strong>The participants (median age: 77 years) generally reported high satisfaction with physician- and nurse communication and confidence/trust at baseline (>55% reported the highest satisfaction in all questions), but lower satisfaction with communication regarding how the treatments could affect them - up to 40% reported not having talked about that at all. Treatment experiences and physical- and emotional well-being remained stable over time. Associations were found between satisfaction with TDM at baseline and how they rated the treatment as a whole at six months, and well-being at six and 12 months. In mCRPC, men's TDM preferences need to be explored, and shared decision-making needs to be facilitated when considering treatment. Furthermore, clinicians need to discuss how the treatment might affect patients' everyday lives when discussing life-prolonging treatments with them.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"462-469"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of an individualised treatment plan compared with a standard exercise programme in women with late-term shoulder impairments after primary breast cancer treatment: a randomised controlled trial. 个体化治疗计划与标准运动计划对原发性乳腺癌晚期肩关节损伤妇女的疗效对比:随机对照试验。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-19 DOI: 10.2340/1651-226X.2025.42737
Kim M Feder, Marianne D Lautrup, Sabrina M Nielsen, Heidi K Egebæk, Hans B Rahr, Robin Christensen, Kim G Ingwersen
{"title":"Effectiveness of an individualised treatment plan compared with a standard exercise programme in women with late-term shoulder impairments after primary breast cancer treatment: a randomised controlled trial.","authors":"Kim M Feder, Marianne D Lautrup, Sabrina M Nielsen, Heidi K Egebæk, Hans B Rahr, Robin Christensen, Kim G Ingwersen","doi":"10.2340/1651-226X.2025.42737","DOIUrl":"10.2340/1651-226X.2025.42737","url":null,"abstract":"<p><strong>Background and purpose: </strong>Research focuses on lymphedema, yet up to 50% face chronic shoulder issues 6 years post-treatment, while rehabilitation for this group is unclear. This trial aimed to assess the clinical effects of a shoulder expert assessment followed by an individualised treatment plan (Intervention Group; IG) compared with standardised exercises delivered as a pamphlet (Control comparator Group; CG), on changes in Shoulder Pain and Disability Index (SPADI) from baseline to week 12.</p><p><strong>Material and methods: </strong>This 12-week, assessor-blinded, parallel-group randomised controlled trial included women with late-term shoulder impairments 3-7 years post-breast cancer. Participants were randomized (1:1 allocation) and stratified by surgery and radiotherapy. Outcomes were assessed at baseline, 4, 8, and 12 weeks. Primary endpoint was SPADI overall score change at 12 weeks, analysed using a mixed model. The trial was designed to detect a between-group difference of 8 points on SPADI overall score after 12 weeks. Secondary outcomes were SPADI pain/function, global perceived effect, changes in shoulder pain numeric rating scale, active and passive shoulder range of motion.</p><p><strong>Results: </strong>After 12-weeks, no between-group difference in SPADI was found between IG and CG (-10.5 and -14.4, respectively), corresponding to a difference of -3.9 points (95% CI -11.9 to 4.1; P = 0.34).</p><p><strong>Interpretation: </strong>The effects on shoulder pain and disability symptoms of a shoulder expert assessment followed by an individualised treatment plan was not superior to standardised exercises delivered as a pamphlet in women with late-term shoulder impairments 3-7 years post-breast cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05277909).</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"448-457"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tolerability, safety and feasibility of metformin combined with chemoradiotherapy in patients with locally advanced cervical cancer: A phase II, randomized study.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-19 DOI: 10.2340/1651-226X.2025.43045
Kjersti Skipar, Tord Hompland, Kjersti V Lund, Christina S Fjeldbo, Kristina Lindemann, Taran P Hellebust, Heidi Lyng, Kjersti Bruheim
{"title":"Tolerability, safety and feasibility of metformin combined with chemoradiotherapy in patients with locally advanced cervical cancer: A phase II, randomized study.","authors":"Kjersti Skipar, Tord Hompland, Kjersti V Lund, Christina S Fjeldbo, Kristina Lindemann, Taran P Hellebust, Heidi Lyng, Kjersti Bruheim","doi":"10.2340/1651-226X.2025.43045","DOIUrl":"10.2340/1651-226X.2025.43045","url":null,"abstract":"<p><strong>Background and purpose: </strong>Locally advanced cervical cancer is treated with chemoradiotherapy. The treatment-related morbidity is high. Tumor hypoxia has prognostic impact and represents a valid, interventional target. This phase II study investigated efficacy of the antidiabetic drug metformin to modify hypoxia according to established biomarkers. Preliminary results including tolerability, safety and feasibility are reported here.</p><p><strong>Patients and methods: </strong>Patients were included in a 1:1 randomized, open-label design, comparing standard chemoradiotherapy ± metformin. Metformin 850 mg twice daily was administered 1 week before and during chemoradiotherapy. Magnetic resonance images (MRI) and tumor biopsies were collected at baseline, after 1 week of metformin treatment, and at brachytherapy for biomarker assessments. Tolerability and safety were determined by treatment completion rates and frequency of adverse events (AEs). Safety was further evaluated by possible increase in MRI-based hypoxia during the first week of metformin. Feasibility was determined by proportion of completed study interventions and imaging and biopsy procedures.</p><p><strong>Results: </strong>In total, 18 and 23 patients were allocated to the intervention and control arm, respectively. Eighteen and 15 patients completed metformin treatment for 1 and 5 weeks. Frequency of AEs ≥ grade 3 was not significantly different between study arms. Most AEs were gastrointestinal toxicities. Tumors with increase in hypoxia during the first week were all below the defined safety limit. A total of 98% of scheduled MR series and biopsies were collected with satisfactory quality.</p><p><strong>Interpretation: </strong>Addition of metformin to chemoradiotherapy is tolerable and safe. Serial sampling of MRI and tumor biopsies for hypoxia biomarker assessment is feasible.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"439-447"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cancer survivorship and functional health: what we need to address in an aging cancer population.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-19 DOI: 10.2340/1651-226X.2025.43076
Anja Mehnert-Theuerkauf, Susanne Oksbjerg Dalton, Christoffer Johansen
{"title":"Cancer survivorship and functional health: what we need to address in an aging cancer population.","authors":"Anja Mehnert-Theuerkauf, Susanne Oksbjerg Dalton, Christoffer Johansen","doi":"10.2340/1651-226X.2025.43076","DOIUrl":"10.2340/1651-226X.2025.43076","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"458-461"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dyadic coping after cancer diagnosis - a longitudinal cluster analysis.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-18 DOI: 10.2340/1651-226X.2025.42561
Anne-Kathrin Köditz, Anja Mehnert-Theuerkauf, Ute Goerling, Tanja Zimmermann, Beate Hornemann, Franziska Springer, Michael Friedrich, Jochen Ernst
{"title":"Dyadic coping after cancer diagnosis - a longitudinal cluster analysis.","authors":"Anne-Kathrin Köditz, Anja Mehnert-Theuerkauf, Ute Goerling, Tanja Zimmermann, Beate Hornemann, Franziska Springer, Michael Friedrich, Jochen Ernst","doi":"10.2340/1651-226X.2025.42561","DOIUrl":"10.2340/1651-226X.2025.42561","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dyadic coping (DC) considers the perception of both the individual and their partner's coping behavior and influences various health outcomes. Given the paucity of research investigating the course of DC after a cancer diagnosis, we explored longitudinal data to find statistically distinct trajectories of DC and to characterize and predict those based on medical, psychological and sociodemographic characteristics.</p><p><strong>Materials and methods: </strong>In this prospective, multicenter study, we assessed patients with primary solid tumors at four measurement points using validated self-report questionnaires: first within 8 weeks of diagnosis, then at 6-month intervals. We measured DC using the Dyadic Coping Inventory (DCI). Clusters were identified via a feature-based clustering approach, characterized with t-tests and chi-squared tests and predicted with multinomial logistic regression.</p><p><strong>Results and interpretation: </strong>We analyzed data from 418 patients in a partnership (mean age 61 years, 55.3% men, 84.8% married). Most prevalent cancers were prostate cancer (25.6%), skin cancer (17.5%) and breast cancer (16.3%). One cluster (33.5%) reported a stable high trajectory of coping behavior, indicating good coping behavior. It had the following characteristics: male (62.9%), regularly employed (57.9%), prostate cancer (34.3%) and childless (27.1%). The remaining sample contained a cluster with increasing coping behavior (34.7%) and another with decreasing coping behavior (31.8%). Lack of regular employment, having children and generalized anxiety are significantly associated with worsening coping behavior. This study is one of the first to examine DC trajectories in a large sample of cancer patients in the early phase after diagnosis. It is essential to understand markers such as psychological stress or family and work-related issues to optimize clinical and psycho-oncological outcomes and facilitate the support or maintenance of couple-related disease management in the long term.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"431-438"},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The trajectory of conditional, recurrence-free, and long-term survival in a complete 10-year cohort of patients with advanced ovarian cancer.
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-03-17 DOI: 10.2340/1651-226X.2025.42994
Nina Groes Kofoed, Henrik Falconer, Matteo Bottai, Sahar Salehi
{"title":"The trajectory of conditional, recurrence-free, and long-term survival in a complete 10-year cohort of patients with advanced ovarian cancer.","authors":"Nina Groes Kofoed, Henrik Falconer, Matteo Bottai, Sahar Salehi","doi":"10.2340/1651-226X.2025.42994","DOIUrl":"10.2340/1651-226X.2025.42994","url":null,"abstract":"<p><strong>Background: </strong>The prognosis in advanced ovarian cancer is generally poor since the majority experience recurrence. Nevertheless, there is a chance of cure and very long-term survival may be achieved. However, traditional survival metrics do not account for the dynamic changes in prognosis over time. Our objectives were to examine conditional, very long-term and recurrence-free survival, in addition risk-factors for recurrence.</p><p><strong>Methods: </strong>In this observational study, all patients diagnosed with advanced ovarian cancer between 2009 and 2018 in the Stockholm/Gotland region, Sweden, were identified in the Swedish Quality Registry of Gynecologic Cancer. Conditional and recurrence-free survival were estimated with the Kaplan Meier method. The association between predefined clinical factors and hazard of death was analysed with Cox regression yielding hazard ratio (HR) with 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 888 patients were analysed of which 87.0% (n = 740) experienced a recurrence and 8.5 % (n = 76) were alive > 10 years. The 5-year conditional survival increased from 33.0% (95% CI: 30-36) in patients who had survived 1 year to 57.0% (95% CI: 50-63) in patients who had already survived 5 years. The median recurrence-free survival was 18 months (95% CI: 16-19). Risk factors associated with recurrence included any residual tumour (> 10 mm; HR: 2.15; 95% CI: 1.65 to 2.80) and evidence of disease at end of first line treatment (HR: 2.40; 95% CI: 1.97 to 2.93; p < 0.001).</p><p><strong>Interpretation: </strong>Conditional survival improves significantly with time survived following an advanced ovarian cancer diagnosis. Most patients experience relapse within 1 year after completing first-line treatment, nevertheless long-term survival is possible.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"423-430"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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