Abstract
Background: There is growing evidence relating inflammation as a prognostic factor in cancer patients. Previous reports have found a small but significant association between systemic inflammation and symptoms in advanced cancer patients. The aim of this study was to analyse the relationship between systemic inflammatory response markers with the symptoms and performance status of advanced cancer patients that have been admitted to an Acute Palliative Care Unit (PCU). Methods: We conducted an observational study including all cancer patients admitted in the PCU between January 2012 and April 2015. We performed a correlation analysis (spearman’s rho) between serum C-reactive-protein (CRP), the modified Glasgow Prognostic Score (mGPS) and Neutrophil-to Lymphocyte Ratio (NLR) with patients symptoms recorded as the Edmonton Symptom Assessment Sytem (ESAS) and performance status recorded as Eastern Cooperative Oncology Group (ECOG), Barthel Index and Palliative Performance Scale (PPS). All data were collected within the first two days of admission. Results: Data of 951 patients were available. The median survival was 17 days. CRP was significantly correlated with ECOG (ρ:0.180, P:0.000), dyspnoea (ρ:0.079, p:0.019), fatigue (ρ:0.162, p < 0.001), anorexia (ρ: 0.103, p:0.002), somnolence (ρ:0.096, p.0.009), wellbeing (ρ:0.012, p < 0.001), Barthel (ρ:-0.178, p < 0.001) and PPS (ρ:0.173, p < 0.001). In relation to mGPS, a significant correlation was found with ECOG (0.116, p:0.001), fatigue (ρ:0.184, p < 0.001), anorexia (ρ:0.107, p.0.003), somnolence (ρ:0.080, p.037), Barthel (ρ:-0.127, p < 0.001) and PPS (ρ:-0.125, p < 0.001). Finally, NLR was significantly correlated with ECOG (ρ:0.112, p0.001), dyspnoea (ρ:0.117, p < 0.001), fatigue (ρ:0.107, p:0.002), Barthel (ρ:-0.115, p < 0.001) and PPS (ρ:-0.100, p:0.002). Conclusions: There is a small but significant correlation between systemic inflammation and symptoms. Further studies are needed to confirm the results and to test this relation in earlier phases of the disease. Legal entity responsible for the study: Hospital Universitario La Paz Funding: None Disclosure: All authors have declared no conflicts of interest.
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