Home parenteral nutrition in elderly patients with cancer: An observational prospective study [Nutrition parentérale à domicile chez la personne âgée atteinte d'un cancer: une étude observationnelle prospective]
Seys P.,Polyclinique Privee |
Tadmouri A.,Clin Search |
Senesse P.,Val dAurelle |
Radji A.,Center Frederic Joliot |
And 5 more authors.
Bulletin du Cancer | Year: 2014
Introduction. Malnutrition is a bad prognostic factor that reduces the quality of life (QoL) in patients with cancer. The objective was to assess the impact of home parenteral nutrition (HPN) on the QoL of elderly malnourished patients with cancer. Patients and methods. This French prospective observational study included patients, aged 70 years or older, with cancer, for whom HPN was prescribed for at least 14 days. The patient, the physician and a family member or home caregiver had to fill in a questionnaire at inclusion and 28 days later. Results. Included patients (n = 221) were mainly suffering from a digestive cancer. After HPN intake, improved weight was noticed in 68% and 14% of patients had reached the target weight. Improved global QoL was reported in 59% of patients. Physicians noticed a significant improvement for the same compounds. Conclusion. These results suggest a benefit of the HPN on the nutritional status and QoL in elderly patients with cancer. Further controlled randomised trials are needed to prove the benefit of HPN in the routine management of these patients. © John Libbey Eurotext.
Mange A.,Montpellier University Hospital Center |
Mange A.,Montpellier University |
Lacombe J.,Montpellier University Hospital Center |
Lacombe J.,Montpellier University |
And 8 more authors.
Clinical Cancer Research | Year: 2012
Purpose: The identification of markers associated with progression to invasive breast cancer (IBC) is a major factor that can guide physicians in the initial therapeutic decision and the management of ductal carcinoma in situ (DCIS). Experimental Design: We examined autoantibody targets in 20 DCIS and 20 IBC patients using protein microarrays and identified humoral responses that can be used to distinguish the two groups. The five most differentially targeted antigens were selected to generate an autoantibody signature for the in situ to invasive breast cancer transition. This signature was next tested on 120 independent samples (61 DCIS and 59 IBC) using specific ELISA assays. The prognosis value of the autoantibody signature was finally evaluated in a cohort of DCIS patients followed for 5 years. Results: A set of five autoantibody targets (RBP-Jk, HMGN1, PSRC1, CIRBP, and ECHDC1) with the highest differential signal intensity found in the protein microarrays experiment was used to establish an autoantibody signature of the DCIS to IBC transition. Using ELISA, this signature significantly discriminated DCIS from IBC [area under the ROC curve (AUC) = 0.794, 95% confidence interval (CI): 0.674-0.877]. Interestingly, our panel could highly distinguish low-grade DCIS from high-grade DCIS exhibiting an AUC of 0.749 (95% CI: 0.581-0.866). Finally, using a Kaplan-Meier analysis, the autoantibody signature could significantly divide the DCIS patients into a poor prognosis group and a good prognosis group (P = 0.01). Conclusion: These results indicate the potential of autoantibody detection as a new prognostic test with possible clinical implications for the management of DCIS. ©2012 AACR.