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Subramanian H, Trivedi R, Fuchsova V, Elder E, Brand A, Howle J, Mann GJ, DeFazio A, Amis T, Kairaitis K. Follow-up assessment of sleep-related symptoms in patients after treatment for cancer: responses to continuous positive airway pressure treatment for co-morbid obstructive sleep apnoea. Sleep Breath 2024; 28:725-733. [PMID: 38051468 DOI: 10.1007/s11325-023-02946-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/09/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE To assess changes in sleep-related symptoms in patients with breast cancer, endometrial cancer and melanoma previously examined for sleep-related symptoms and the presence of PSG (polysomnography)-determined OSA, ≥ 3 years post-treatment; and to evaluate how CPAP treatment affects sleep-related symptoms in patients previously diagnosed with OSA. METHODS Patients initially recruited from breast cancer, endometrial cancer, and melanoma follow-up clinics at Westmead Hospital (Sydney, Australia) participated in this questionnaire-based study. Demographic and change in cancer status data were collected at follow-up. Patients completed the Pittsburgh Sleep Quality Index [poor sleep quality, PSQITOTAL ≥ 5au], Insomnia Severity Index, Epworth Sleepiness Scale and Functional Outcomes of Sleep Questionnaire; with ΔPSQITOTAL ≥ 3au indicating a clinically meaningful change in sleep quality over follow-up. PSG-determined OSA was confirmed using the apnoea-hypopnoea index. CPAP compliance was determined via self-report (CPAP compliant, CPAP; not compliant, non-CPAP). Logistic regression models determined if changes in cancer status, AHI, cancer subgroup or CPAP treatment was predictive of ΔPSQITOTAL ≥ 3 au and p < 0.05 indicated statistical significance. RESULTS The 60 patients recruited had breast cancer (n = 22), endometrial cancer (n = 15), and melanoma (n = 23). Cancer subgroups were similarly aged, and all had median follow-up PSQITOTAL scores ≥ 5au; breast cancer patients scoring the highest (p < 0.05). The CPAP group had significantly reduced PSQITOTAL scores (p = 0.02) at follow-up, unlike the non-CPAP group. Cancer subgroups had similar median ISITOTAL, ESSTOTAL and FOSQ-10TOTAL scores at follow-up, regardless of CPAP treatment. There were no significant predictors of ΔPSQITOTAL ≥ 3 au at follow-up. CONCLUSION Sleep-related symptoms persist in patients with cancer ≥ 3 years after treatment, although these symptoms improve with CPAP. Future studies should evaluate how CPAP affects survival outcomes in cancer patients with comorbid OSA.
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Affiliation(s)
- Harini Subramanian
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, Australia
| | - Ritu Trivedi
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, Australia
| | - Veronika Fuchsova
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Elisabeth Elder
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
- Breast Cancer Institute, Westmead Hospital, Westmead, Australia
| | - Alison Brand
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, Australia
| | - Julie Howle
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
- Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Blacktown, Australia
- Melanoma Institute Australia, The University of Sydney, Camperdown, Australia
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Camperdown, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Anna DeFazio
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- The Daffodil Centre, The University of Sydney, Camperdown, Australia
| | - Terence Amis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, Australia
| | - Kristina Kairaitis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, Australia.
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, Australia.
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Yin Y, Niu Q, Wei Z, Wang Y, Li G, Zhang W, Guo K, Yao X. Research on the toxicological prognostic significance of age-related genes in endometrial cancer unveiling key factors in patient prognosis. ENVIRONMENTAL TOXICOLOGY 2024. [PMID: 38591852 DOI: 10.1002/tox.24219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/11/2024] [Accepted: 03/04/2024] [Indexed: 04/10/2024]
Abstract
This study investigates the influence of aging-related genes on endometrial cancer, a prominent gynecological malignancy with rising incidence and mortality. By analyzing gene expression differences between cancerous and normal endometrial tissues, 42 aging-related genes were identified as differentially expressed. Utilizing the TCGA-UCEC sample, consensus clustering divided the samples into two molecular subgroups, Aging low and Aging high, based on their expression profiles. These subgroups showed distinct prognoses and survival rates, with the Aging high group associated with DNA repair and cell cycle pathways, and the Aging low group showing suppressed metabolic pathways and increased immune cell infiltration, suggesting a potential for better immunotherapy outcomes. Mutation analysis did not find significant differences in mutation frequencies between the groups, but a high Tumor Mutation Burden (TMB) correlated with better prognosis. A risk score model was also developed, showcasing significant prognostic power. Further analysis of the SIX1 gene revealed its overexpression in cancer cells. Drug sensitivity tests indicated that the low-risk group might respond better to chemotherapy. This research underscores the significance of aging-related genes in endometrial cancer, offering insights into their prognostic value and therapeutic potential, which could lead to personalized treatment approaches and enhanced patient management.
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Affiliation(s)
- Yongchao Yin
- Department of Second Ward of Gynecology, Xingtai People's Hospital, Xingtai, China
| | - Qian Niu
- Department of Ouclar Trauma, Hebei Provincial Eye Hospital, Xingtai, China
| | - Zhiqiang Wei
- Department of Operating Room, Xingtai People's Hospital, Xingtai, China
| | - Yefei Wang
- Department of Operating Room, Xingtai People's Hospital, Xingtai, China
| | - Gang Li
- Department of Operating Room, Xingtai People's Hospital, Xingtai, China
| | - Weican Zhang
- Department of Fourth Ward of Gynecology, Xingtai People's Hospital, Xingtai, China
| | - Kai Guo
- Department of Neurosurgery, Xingtai People's Hospital, Xingtai, China
| | - Xinyu Yao
- Department of Anesthesiology, Xingtai People's Hospital, Xingtai, China
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