Associations Among Hypogonadism, C-Reactive Protein, Symptom Burden, and Survival in Male Cancer Patients with Cachexia: A Preliminary Report
Associations Among Hypogonadism, C-Reactive Protein, Symptom Burden, and Survival in Male Cancer Patients with Cachexia: A Preliminary Report
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DOI：
10.1016/j.jpainsymman.2009.09.021
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发表时间：
2010-06-01
影响因子：
4.7
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
--
作者：
Del Fabbro, Egidio;Hui, David;Bruera, Eduardo
Context. Cachexia is characterized by muscle wasting, anorexia, and elevated inflammatory markers. In patients without cancer, hypogonadism is associated with lower lean body mass, increased symptom burden, and decreased survival. Hypogonadism in cancer cachexia could exacerbate symptoms, facilitate a proinflammatory state, and decrease survival.Objectives. To explore the relationships among these factors, a retrospective study of male cancer patients was conducted.Methods. The charts of 98 consecutive male patients referred to a cachexia clinic at a comprehensive cancer center were reviewed. All patients reported weight loss of >5% within the preceding six months; the median age was 60 years. Fifty-seven (58%) had serum C-reactive protein (CRP), and 68 (69%) had total testosterone evaluated. Symptoms were evaluated by the Edmonton Symptom Assessment Scale.Results. Median CRP was 20 mg/L, and median testosterone level was 185 ng/dL (6.42 nmol/L) (normal 240 ng/dL or 8.36 nmol/L). There was an inverse correlation between testosterone and CRP levels (P < 0.01). Lower testosterone was associated with increased dyspnea and insomnia (P < 0.05). Poor appetite and insomnia (P < 0.05) correlated with elevated CRP. Survival of patients with testosterone levels.185 ng/dL (6.42 nmol/L) was decreased compared with that of those with levels >185 ng/dL (13 vs. 62 weeks, P = 0.004). Patients with CRP levels >10 mg/L had decreased survival compared with those with levels
