Patient-reported outcomes after oncologic hepatic resection predict the risk of delayed readiness to return to intended oncologic therapy (RIOT)

作者全名：Wang, Xin Shelley; Shi, Qiuling; Shen, Shu-En; Letona, Elizabeth; Kamal, Mona; Cleeland, Charles S.; Aloia, Thomas; Gottumukkala, Vijaya

作者地址：[Wang, Xin Shelley; Shen, Shu-En; Letona, Elizabeth; Kamal, Mona; Cleeland, Charles S.] Univ Texas MD Anderson Canc Ctr, Dept Symptom Res, Unit 1450,1515 Holcombe Blvd, Houston, TX 77030 USA; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China; [Aloia, Thomas] Ascension Hlth, St Louis, MO USA; [Gottumukkala, Vijaya] Univ Texas MD Anderson Canc Ctr, Dept Anesthesia & Perioperat Med, Houston, TX 77030 USA

通信作者：Wang, XS (通讯作者)，Univ Texas MD Anderson Canc Ctr, Dept Symptom Res, Unit 1450,1515 Holcombe Blvd, Houston, TX 77030 USA.

来源：EJSO

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001243527000001

JCR分区：Q1

影响因子：3.5

年份：2024

卷号：50

期号：7

开始页：　

结束页：　

文献类型：Article

关键词：Patient-reported outcome; MDASI; Perioperative care; Liver surgery; Functional recovery; Symptom burden; Return to intended oncologic therapy

摘要：Background: Optimal surgical recovery is critical to readiness to return to intended oncologic therapy (RIOT). The current study defined the value of patient-reported outcomes (PROs) in predicting the risk for delayed RIOT after oncologic hepatic resection. Methods: In a prospective longitudinal study, perioperative symptoms were assessed using a valid PRO assessment tool, the MD Anderson Symptom Inventory module for hepatectomy perioperative care (MDASI-PeriOpHep), for 4 weeks after surgery. The timed up and go test (TUGT) was administered before surgery, by discharge day, and at the first postoperative follow-up visit. Multivariate logistic regression analysis assessed the predictive value of PROs for delayed RIOT. Results: We enrolled 210 patients and analyzed 148 patients who received adjuvant chemotherapy and contributed more than 3 PRO assessments postoperatively. About 36 percent of the patients had delayed RIOT ( >5 weeks, range 1 -14 weeks). MDASI scores for drowsiness, fatigue, dry mouth, and interference with general activity, walking, and work on day 7 after discharge and MDASI scores for incisional tightness, fatigue, dry mouth, shortness of breath, and interference with work on day 14 after discharge were associated with delayed RIOT (all P < 0.05). Walking and general activity items on the MDASI-Interference subscale on day 7 after discharge were highly correlated with prolonged TUGT scores at discharge (P < 0.01). Conclusion: We defined clinically meaningful PROs on MDASI-PeriOp-Hep after hepatic resection that predicted increased risk of delayed RIOT. These findings highlight the importance PROs for monitoring symptoms and functioning 1 -2 weeks after discharge to be implementing into perioperative care.

基金机构：US National Cancer Institute [R01 CA205146, P30 CA016672]

基金资助正文：This work was funded by grants from the US National Cancer Institute: R01 CA205146 (Improving Recovery After Major Cancer Surgery Using Patient-Reported Outcomes) to Xin Shelley Wang, and P30 CA016672 (MD Anderson Cancer Center Support Grant) . We thank Erica Goodoff, Senior Scientific Editor in the Research Medical Library at The University of Texas MD Anderson Cancer Center, for editing this article.