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Nutr Cancer. 2018 Nov-Dec;70(8):1283-1289. doi: 10.1080/01635581.2018.1557213. Epub 2019 Jan 20.

Low Transthyretin Levels Predict Poor Prognosis in Cancer Patients in Palliative Care Settings.

Author information

1
a Department of Palliative Medicine , National Cancer Center Hospital East , Kashiwa , Japan.
2
b bDivision of Biomarker Discovery, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan.
3
c cDepartment of Palliative Medicine , Osaka City General Hospital , Osaka , Japan.
4
d dPalliative Care Team and Seirei Hospice , Seirei Mikatahara General Hospital , Hamamatsu , Japan.
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e eDepartment of Palliative Medicine , Suita Tokushukai Hospital , Suita , Japan.
6
f fMegumi Zaitaku Clinic , Yokohama , Japan.
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g gDivision of Community-based Medicine and Primary Care , University of the Ryukyus Hospital , Okinawa , Japan.
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h hDepartment of Palliative Medicine , Shizuoka Saiseikai General Hospital , Shizuoka , Japan.
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i Saiseikai Matsusaka General Hospital , Matsusaka , Japan.
10
j Department of Palliative Care , Aichi Cancer Center Hospital , Nagoya , Japan.
11
k Department of Palliative Medicine , Wakayama Medical University Hospital Oncology Center , Wakayama , Japan.
12
l Department of Psychosomatic Medicine , National Hospital Organization Kinki-Chuo Chest Medical Center , Sakai , Japan.
13
m Matsue City Hospital , Matsue , Japan.
14
n Gratia Hospital Hospice , Mino , Japan.

Abstract

OBJECTIVES:

Although transthyretin (TTR) is a nutritional indicator and is influenced by systemic inflammation, it may be a good prognostic indicator for cancer patients in palliative care settings. This study investigates the correlation between low TTR levels and survival among cancer patients in palliative care settings.

METHODS:

This was a sub-analysis of a prospective, multicenter cohort study. Patients who had advanced-stage cancer and who were newly referred to palliative care services were eligible to participate; however, those receiving anti-tumor therapy were excluded. Survival analyses were performed to clarify predictors of poor prognosis.

RESULTS:

A total of 144 patients were enrolled (45.1% female; median age, 72 years). Cox regression analysis revealed that low TTR levels (<10.9 mg/l) (hazard ratio 1.74, P = 0.025), poor muscle power (1.71, P = 0.045), and fatigue (1.89, P = 0.024) were predictors of poor prognosis. Median survival in patients with low TTR levels (<10.9 mg/l) was 26 days, which was significantly shorter than those with high TTR levels (≥10.9 mg/l) (50 days; P < 0.001).

CONCLUSION:

Low TTR levels may be indicators for poor prognosis among cancer patients in palliative care settings.

PMID:
30663397
DOI:
10.1080/01635581.2018.1557213
[Indexed for MEDLINE]

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