Characteristics of Cancer-Related Fatigue and an Efficient Model to Identify Patients with Gynecological Cancer Seeking Fatigue-Related Management
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures
2.3. Statistics
3. Results
4. Discussion
4.1. Summary of the Main Results
4.2. The Other Predictive Model
4.3. Results in the Context of Published Literature
4.4. Treatment for Cancer-Related Fatigue
4.5. Strengths and Weaknesses
4.6. Implications for Practice and Future Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patients (N = 190) | |
---|---|
Age, mean ± SD | 56.87 ± 11.89 |
Cancer type, n (%) | |
Endometrium cancer | 76 (40.0) |
Cervical cancer | 55 (28.9) |
Ovarian cancer | 59 (31.1) |
FIGO stage, n (%) | |
I | 95 (50.0) |
II | 29 (15.3) |
III | 45 (23.7) |
IV | 21 (11.1) |
ECOG performance status, n (%) | |
0 | 55 (28.9) |
1 | 122 (64.2) |
2 | 12 (6.3) |
3 | 1 (0.5) |
Current disease condition, n (%) | |
Complete response | 48 (25.3) |
Partial response | 3 (1.6) |
Stable disease | 134 (70.5) |
Progressive disease | 5 (2.6) |
ICD-10 diagnosed fatigue, n (%) | |
No fatigue | 90 (47.4) |
Non-cancer-related fatigue | 81 (42.6) |
CRF | 19 (10.0) |
BFI-T questionnaire-based fatigue, n (%) | |
No: 0 | 93 (48.9) |
Mild: 1–3 | 61 (32.1) |
Moderate to severe: ≥4 | 36 (18.9) |
Fatigue-related management, n (%) | |
Never | 42 (22.1) |
Receive limited (≤5) managements | 65 (34.2) |
Receive multiple (>5) managements | 83 (43.7) |
Fatigue-Related Management | ||||
---|---|---|---|---|
0 (n = 42) | 1 (n = 65) | 2 (n = 83) | p-Value | |
Age, years, mean ± SD | 57.96 ± 8.97 | 58.1 ± 12.96 | 55.35 ± 12.25 | 0.3021 |
≥60, n (%) | 22 (52.4) | 33 (50.8) | 52 (62.7) | |
<60, n (%) | 20 (47.6) | 32 (49.2) | 31 (37.3) | 0.2965 |
Cancer type, n (%) | ||||
Endometrial cancer | 5 (11.9) | 26 (40.0) | 45 (54.2) | |
Cervical cancer | 8 (19.0) | 22 (33.8) | 25 (30.1) | |
Ovarian cancer | 29 (69.0) | 17 (26.2) | 13 (15.7) | <0.0001 |
FIGO stage, n (%) | ||||
I | 39 (92.9) | 29 (44.6) | 27 (32.5) | <0.0001 |
II | 1 (2.4) | 15 (23.1) | 13 (15.7) | |
III | 1 (2.4) | 15 (23.1) | 29 (34.9) | |
IV | 1 (2.4) | 6 (9.2) | 14 (16.9) | |
ECOG, n (%) | ||||
0 | 26 (61.9) | 15 (23.1) | 14 (16.9) | <0.0001 |
1 | 16 (38.1) | 46 (70.8) | 60 (72.3) | |
2 | 0 (0.0) | 3 (4.6) | 9 (10.8) | |
3 | 0 (0.0) | 1 (1.5) | 0 (0.0) | |
Current disease condition, n (%) | ||||
Complete response + partial response | 26 (61.9) | 11 (16.9) | 14 (16.9) | <0.0001 |
Stable disease + progressive disease | 16 (38.1) | 54 (83.1) | 69 (83.1) | |
ICD-10-diagnosed fatigue, n (%) | ||||
No fatigue | 27 (64.3) | 29 (44.6) | 34 (41.0) | |
Non-cancer-related fatigue | 13 (31.0) | 27 (41.5) | 41 (49.4) | |
CRF | 2 (4.8) | 9 (13.8) | 8 (9.6) | 0.1016 |
BFI-T questionnaire-based fatigue, n (%) | ||||
No: 0 | 27 (64.3) | 28 (43.1) | 38 (45.8) | |
Mild: 1–3 | 13 (31.0) | 21 (32.3) | 27 (32.5) | |
Moderate to severe: ≥4 | 2 (4.8) | 16 (24.6) | 18 (21.7) | 0.0731 |
FACT-G7, mean ± SD | ||||
Total score | 24.00 ± 3.13 | 20.28 ± 4.67 | 20.90 ± 5.62 | 0.0004 |
Physical well-being | 10.38 ± 1.74 | 9.03 ± 2.23 | 9.10 ± 2.63 | 0.0061 |
Emotional well-being | 3.33 ± 0.69 | 2.58 ± 0.95 | 2.78 ± 1.12 | 0.0006 |
Functional well-being | 10.29 ± 1.38 | 8.66 ± 2.28 | 9.02 ± 2.63 | 0.0014 |
Cancer treatment in recent 1 week, n (%) | ||||
No | 42 (100.0) | 42 (64.6) | 54 (65.1) | |
Yes | 0 (0.0) | 23 (35.4) | 29 (34.9) | <0.0001 |
Fatigue-Related Management | 1 vs. 0 | 2 vs. 0 | 2 vs. 1 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total (N = 190) | 0 (n = 42) | 1 (n = 65) | 2 (n = 83) | p-Value * | Difference Ls-Mean (95% CI) | p-Value | Difference Ls-Mean (95% CI) | p-Value | Difference Ls-Mean (95% CI) | p-Value | |
Cancer-related symptoms, mean ± SD | 13.04 ± 16.17 | 5.74 ± 8.62 | 15.17 ± 14.97 | 15.07 ± 18.85 | 0.0004 | 4.41 (−2.83, 11.64) | 0.2816 | 2.77 (−4.75, 10.28) | 0.5929 | −1.64 (−7.25, 3.96) | 0.7541 |
Pain | 0.86 ± 2.04 | 0.29 ± 1.29 | 1.03 ± 2.25 | 1.02 ± 2.15 | 0.0471 | 0.29 (−0.65, 1.24) | 0.6812 | 0.07 (−0.91, 1.06) | 0.9765 | −0.22 (−0.96, 0.51) | 0.7412 |
Fatigue | 2.21 ± 2.63 | 0.83 ± 1.86 | 2.69 ± 2.62 | 2.53 ± 2.76 | 0.0002 | 1.56 (0.36, 2.76) | 0.0082 | 1.35 (0.10, 2.59) | 0.0317 | −0.21 (−1.14, 0.71) | 0.8390 |
Nausea | 0.88 ± 2.13 | 0.07 ± 0.46 | 0.82 ± 2.04 | 1.35 ± 2.56 | 0.0015 | 0.19 (−0.74, 1.12) | 0.8423 | 0.50 (−0.47, 1.46) | 0.3887 | 0.31 (−0.41, 1.03) | 0.5519 |
Vomiting | 0.55 ± 1.70 | 0.00 ± 0.00 | 0.46 ± 1.56 | 0.89 ± 2.12 | 0.0086 | 0.11 (−0.65, 0.86) | 0.9158 | 0.37 (−0.42, 1.15) | 0.4506 | 0.26 (−0.33, 0.84) | 0.5337 |
Depression | 1.41 ± 2.35 | 1.00 ± 1.85 | 1.66 ± 2.66 | 1.41 ± 2.32 | 0.8007 | 0.43 (−0.67, 1.54) | 0.5557 | 0.07 (−1.07, 1.22) | 0.9830 | −0.36 (−1.22, 0.49) | 0.5598 |
Constipation | 1.01 ± 2.19 | 0.88 ± 2.05 | 1.49 ± 2.68 | 0.69 ± 1.75 | 0.3448 | 0.32 (−0.72, 1.37) | 0.6801 | −0.61 (−1.69, 0.48) | 0.3340 | −0.93 (−1.74, −0.12) | 0.0200 |
Alopecia | 1.15 ± 2.46 | 0.33 ± 1.22 | 1.88 ± 3.13 | 0.99 ± 2.19 | 0.0194 | 0.94 (−0.19, 2.07) | 0.1156 | −0.01 (−1.18, 1.17) | 0.9998 | −0.95 (−1.82, −0.07) | 0.0317 |
Diarrhea | 0.53 ± 1.49 | 0.48 ± 1.40 | 0.45 ± 1.24 | 0.63 ± 1.71 | 0.8727 | −0.34 (−1.02, 0.35) | 0.4175 | −0.32 (−1.03, 0.39) | 0.4739 | 0.02 (−0.51, 0.55) | 0.9966 |
Insomnia | 2.07 ± 2.84 | 1.50 ± 2.42 | 2.46 ± 3.12 | 2.05 ± 2.78 | 0.1922 | 0.65 (−0.71, 2.00) | 0.4359 | 0.19 (−1.22, 1.59) | 0.9282 | −0.46 (−1.51, 0.59) | 0.5348 |
Shortness of breath | 0.62 ± 1.59 | 0.33 ± 1.18 | 0.45 ± 1.20 | 0.90 ± 1.96 | 0.2743 | −0.03 (−0.78, 0.73) | 0.9934 | 0.46 (−0.32, 1.25) | 0.3013 | 0.49 (−0.09, 1.08) | 0.1146 |
Anorexia | 0.92 ± 2.16 | 0.02 ± 0.15 | 1.08 ± 2.41 | 1.24 ± 2.38 | 0.0012 | 0.38 (−0.60, 1.37) | 0.5588 | 0.34 (−0.68, 1.36) | 0.6472 | −0.04 (−0.80, 0.72) | 0.9887 |
Weight loss | 0.41 ± 1.53 | 0.00 ± 0.00 | 0.25 ± 0.83 | 0.73 ± 2.15 | 0.0247 | −0.12 (−0.81, 0.58) | 0.8907 | 0.3 (−0.42, 1.02) | 0.5240 | 0.42 (−0.12, 0.95) | 0.1609 |
Nutrition imbalance | 0.44 ± 1.65 | 0.00 ± 0.00 | 0.46 ± 1.74 | 0.64 ± 1.95 | 0.0506 | 0.01 (−0.77, 0.79) | 0.9991 | 0.06 (−0.75, 0.87) | 0.9773 | 0.05 (−0.56, 0.65) | 0.9794 |
FACT-G7, mean ± SD | |||||||||||
Total score | 21.37 ± 5.03 | 24.00 ± 3.13 | 20.28 ± 4.67 | 20.90 ± 5.62 | 0.0004 | −2.25 (−4.48, −0.03) | 0.0467 | −1.26 (−3.57, 1.06) | 0.3537 | 1.00 (−0.73, 2.72) | 0.3446 |
Physical well-being | 9.36 ± 2.37 | 10.38 ± 1.74 | 9.03 ± 2.23 | 9.10 ± 2.63 | 0.0061 | −0.67 (−1.77, 0.43) | 0.2848 | −0.41 (−1.56, 0.73) | 0.6035 | 0.25 (−0.60, 1.11) | 0.7465 |
Emotional well-being | 2.84 ± 1.01 | 3.33 ± 0.69 | 2.58 ± 0.95 | 2.78 ± 1.12 | 0.0006 | −0.62 (−1.07, −0.17) | 0.0053 | −0.38 (−0.85, 0.09) | 0.1210 | 0.23 (−0.12, 0.58) | 0.2451 |
Functional well-being | 9.18 ± 2.35 | 10.29 ± 1.38 | 8.66 ± 2.28 | 9.02 ± 2.63 | 0.0014 | −0.97 (−2.00, 0.06) | 0.0668 | −0.46 (−1.53, 0.61) | 0.5010 | 0.51 (−0.29, 1.31) | 0.2740 |
Fatigue-Related Management | 1 vs. 0 | 2 vs. 0 | 1 vs. 0 | 2 vs. 0 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
0 (n = 42) | 1 (n = 65) | 2 (n = 83) | p-Value | AUC (95% CI) | AUC (95% CI) | Adjusted OR (95% CI) | p-Value | Adjusted OR (95% CI) | p-Value | |
Cancer type, n (%) | 0.73 (0.64–0.82) | 0.80 (0.72–0.88) | ||||||||
Ovarian cancer | 29 (69.0) | 17 (26.2) | 13 (15.7) | <0.0001 | 1.00 | 1.00 | ||||
Cervical cancer | 8 (19.0) | 22 (33.8) | 25 (30.1) | 2.99 (0.85–10.49) | 0.7327 | 3.64 (1.03–12.94) | 0.9058 | |||
Endometrial cancer | 5 (11.9) | 26 (40.0) | 45 (54.2) | 5.85 (1.52–22.51) | 0.0610 | 11.49 (3.04–43.48) | 0.0049 | |||
FIGO Stage, n (%) | 0.74 (0.67–0.81) | 0.80 (0.74–0.87) | ||||||||
I | 39 (92.9) | 29 (44.6) | 27 (32.5) | 1.00 | 1.00 | |||||
>I | 3 (7.1) | 36 (55.4) | 56 (67.5) | <0.0001 | 10.92 (2.64–45.16) | 0.0010 | 15.42 (3.80–62.65) | 0.0001 | ||
ECOG performance status, n (%) | 0.69 (0.60–0.78) | 0.73 (0.64–0.81) | ||||||||
0 | 26 (61.9) | 15 (23.1) | 14 (16.9) | 1.00 | 1.00 | |||||
≥1 | 16 (38.1) | 50 (76.9) | 69 (83.1) | <0.0001 | 1.00 (0.18–5.50) | 0.9987 | 2.58 (0.44–15.15) | 0.2934 | ||
Current disease condition | 0.73 (0.64–0.81) | 0.73 (0.65–0.82) | ||||||||
Complete response + partial response | 26 (61.9) | 11 (16.9) | 14 (16.9) | 1.00 | 1.00 | |||||
Stable disease + progressive disease | 16 (38.1) | 54 (83.1) | 69 (83.1) | <0.0001 | 4.59 (0.82–25.82) | 0.9844 | 1.89 (0.32–11.17) | 0.9788 | ||
Total score (FACT-G7) | 0.70 (0.62–0.78) | 0.65 (0.57–0.73) | ||||||||
≥22 | 35 (83.3) | 28 (43.1) | 44 (53.0) | 1.00 | 1.00 | |||||
<22 | 7 (16.7) | 37 (56.9) | 39 (47.0) | 0.0002 | 9.09 (2.82–29.28) | 0.0002 | 5.63 (1.70–18.64) | 0.0047 | ||
Cancer treatment in recent 1 week | 0.68 (0.62–0.74) | 0.67 (0.62–0.73) | ||||||||
No | 42 (100.0) | 42 (64.6) | 54 (65.1) | 1.00 | 1.00 | |||||
Yes * | 0 (0.0) † | 23 (35.4) | 29 (34.9) | <0.0001 | ||||||
AUC (95% CI): combined factors ‡ | 0.91 (0.86–0.97) | 0.95 (0.91–0.98) |
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Wang, Y.-W.; Ou, Y.-C.; Lin, H.; Huang, K.-S.; Fu, H.-C.; Wu, C.-H.; Chen, Y.-Y.; Huang, S.-W.; Tu, H.-P.; Tsai, C.-C. Characteristics of Cancer-Related Fatigue and an Efficient Model to Identify Patients with Gynecological Cancer Seeking Fatigue-Related Management. Cancers 2023, 15, 2181. https://doi.org/10.3390/cancers15072181
Wang Y-W, Ou Y-C, Lin H, Huang K-S, Fu H-C, Wu C-H, Chen Y-Y, Huang S-W, Tu H-P, Tsai C-C. Characteristics of Cancer-Related Fatigue and an Efficient Model to Identify Patients with Gynecological Cancer Seeking Fatigue-Related Management. Cancers. 2023; 15(7):2181. https://doi.org/10.3390/cancers15072181
Chicago/Turabian StyleWang, Ying-Wen, Yu-Che Ou, Hao Lin, Kun-Siang Huang, Hung-Chun Fu, Chen-Hsuan Wu, Ying-Yi Chen, Szu-Wei Huang, Hung-Pin Tu, and Ching-Chou Tsai. 2023. "Characteristics of Cancer-Related Fatigue and an Efficient Model to Identify Patients with Gynecological Cancer Seeking Fatigue-Related Management" Cancers 15, no. 7: 2181. https://doi.org/10.3390/cancers15072181