Heart Failure ; psychology ; Humans ; Liver Failure ; psychology ; Neoplasms ; psychology ; Neurodegenerative Diseases ; psychology ; Organ Transplantation ; Quality of Life ; psychology ; Renal Insufficiency ; psychology

OBJECTIVE: To analyze the changes in psychological distress and quality of life of patients with advanced liver cancer after transformation therapy. METHODS: This study was conducted among 60 patients with advanced liver cancer undergoing transformation therapy from July, 2019 to March, 2022. Before and after 2-10 cycles of treatment, the patients were assessed for psychological distress and quality of life using a psychological stress thermometer and the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). RESULTS: The patients showed significantly lowered scores for psychological distress after transformation therapy (P < 0.01) with decreased psychological stress, emotional factors, tension, worry, sleep problems, memory decline and inattention, physical factors, pain, fatigue, eating problems and dyspepsia (P < 0.05). The total score of quality of life and the scores for physical status, social and family status, emotional status, functional status and hepatobiliary-specific items were all significantly lowered after the treatment (P < 0.05). CONCLUSION In patients with advanced liver cancer, the psychological distress involves mainly the emotional factors and physical factors. Transformation therapy can significantly relieve psychological distress of the patients and improve their quality of life.
Humans ; Quality of Life/psychology* ; Surveys and Questionnaires ; Psychological Distress ; Fatigue/psychology* ; Stress, Psychological ; Neoplasms ; Liver Neoplasms

BACKGROUND/AIMS: Solitary hepatocellular carcinoma (HCC) is a subgroup of HCCs. We aimed to establish nomograms for predicting the survival of solitary HCC patients after hepatectomy. METHODS: A total of 538 solitary HCC patients were randomly classified into training and validation sets. A Cox model was used to identify predictors of overall survival (OS) in the training set. A nomogram was generated based on these predictors and was validated using the validation set. RESULTS: Tumor size, microvascular invasion, and major vascular invasion were significantly associated with OS in the training set. Nomograms were developed based on these predictors in the multivariate analysis. The C-index was 0.75 for the OS nomogram and 0.72 for the recurrence-free survival nomogram. Compared to the index of conventional staging systems for predicting survival (0.71 for Barcelona Clinic Liver Cancer, 0.66 for the seventh American Joint Committee on Cancer, 0.68 for Cancer of the Liver Italian Program, and 0.70 for Hong Kong Liver Cancer), the index of the OS nomogram was significantly higher. Moreover, the calibration curve fitted well between the predicted and observed survival rate. Similarly, in the validation set, the nomogram discrimination was superior to those of the four staging systems (p<0.001). CONCLUSIONS: The nomograms demonstrated good discrimination performance in predicting 3- and 5-year survival rates for solitary HCCs after hepatectomy.
Calibration ; Carcinoma, Hepatocellular* ; Discrimination (Psychology) ; Hepatectomy* ; Hong Kong ; Humans ; Joints ; Liver ; Liver Neoplasms ; Multivariate Analysis ; Nomograms* ; Prognosis ; Survival Rate

PURPOSE: This study was done to explore the relationship of social support and meaning of life to suicidal thoughts among patients with cancer. METHODS: Data were collected by questionnaires from 138 patients who had been in cancer treatment at medical clinics and 8 patients who were members of an internet cancer association. The data were collected between August and November 2009 and analyzed using SPSS 12.0. RESULTS: Of the participants, 47.3% reported having had suicidal thoughts and 16.4% had attempted suicide since the diagnosis of cancer. The study participants received most support from family members, but 73.3% reported experiencing an existential vacuum. The suicide attempt group had significantly higher scores according to gender, age, level of education, diagnosis, treatment modality, level of activity, caregiver and social support compare to the suicide thought group. Suicidal thoughts were negatively related to social support and meaning of life was positively associated with social support. Support from family and friends and diagnosis explained 50.0% of variance for suicidal thoughts with 36.0% of variance being explained by family support. CONCLUSION: Nurses should be able to identify risk factors for suicide in cancer patients. Prevention and intervention efforts need to be directed toward improving social support, family support in particular, and assisting patients finding meaning in life after a diagnosis of cancer.
Adult ; Age Factors ; Aged ; Breast Neoplasms/*psychology ; Female ; Humans ; Liver Neoplasms/*psychology ; Male ; Middle Aged ; *Quality of Life ; Questionnaires ; Sex Factors ; *Social Support ; Suicide, Attempted/*prevention & control

OBJECTIVE: This study was performed to develop a program for predicting individual cancer risk and to validate its discrimination power between case and control groups. METHODS: The author used the five databases for searching journals about risk factors of six major cancers in Koreans: stomach, liver, colorectal, breast, uterine cervix and lung cancer. The risk models were selected from journals presenting a multivariate linear logistic regression analysis. The baseline hazards which had no risk factors were calculated, and a cancer risk assessment program was developed using relative risks based on risk factors' combination and baseline hazards. Case-control study was performed for five years to validate the program. RESULTS: The discrimination power between case and control was 0.827 in stomach cancer, 0.949 in liver cancer, 0.594 in colorectal cancer, 0.587 in breast cancer, 0.708 in uterine cervix cancer and 0.663 in lung cancer. The estimated cancer probabilities were higher in all case groups compared to the control groups. CONCLUSION: The developed program is considered to be a valid tool for estimating probabilities of cancer development in Koreans. It is expected to be useful for the assessment of individual cancer risks, the selection of screening tools and preventive options for risk reduction.
Breast ; Breast Neoplasms ; Case-Control Studies ; Cervix Uteri ; Colorectal Neoplasms ; Discrimination (Psychology) ; Female ; Liver ; Liver Neoplasms ; Logistic Models ; Lung Neoplasms ; Mass Screening ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Stomach ; Stomach Neoplasms

BACKGROUND/AIMS: The failure to correctly differentiate between intrahepatic cholangiocarcinoma (CC) and hepatocellular carcinoma (HCC) is a significant clinical problem, particularly in terms of the different treatment goals for both cancers. In this study a specific gene expression profile to discriminate these two subgroups of liver cancer was established and potential diagnostic markers for clinical use were analyzed. METHODS: To evaluate the gene expression profiles of HCC and intrahepatic CC, Oligonucleotide arrays (AffymetrixU133A) were used. Overexpressed genes were checked for their potential use as new markers for discrimination and their expression values were validated by reverse transcription polymerase chain reaction and immunohistochemistry analyses. RESULTS: 695 genes/expressed sequence tags (ESTs) in HCC (245 up-/450 down-regulated) and 552 genes/ESTs in CC (221 up-/331 down-regulated) were significantly dysregulated (p < 0.05, fold change >2, ≥70%). Using a supervised learning method, and one-way analysis of variance a specific 270-gene expression profile that enabled rapid, reproducible differentiation between both tumors and non-malignant liver tissues was established. A panel of 12 genes (e.g., HSP90β, ERG1, GPC3, TKT, ACLY, and NME1 for HCC; SPT2, T4S3, CNX43, TTD1, HBD01 for CC) were detected and partly described for the first time as potential discrimination markers. CONCLUSIONS: A specific gene expression profile for discrimination of primary liver cancer was identified and potential marker genes with feasible clinical impact were described.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Discrimination (Psychology)* ; Gene Expression* ; Immunohistochemistry ; Learning ; Liver Neoplasms ; Liver* ; Methods ; Oligonucleotide Array Sequence Analysis* ; Polymerase Chain Reaction ; Reverse Transcription ; Transcriptome

PURPOSE: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. METHODS: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. RESULTS: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. CONCLUSION: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.
Adult ; Aged ; Anxiety ; Carcinoma, Hepatocellular/diagnosis/*psychology/secondary ; Checklist ; Cluster Analysis ; Cross-Sectional Studies ; Demography ; Depression ; Fatigue ; Female ; Humans ; Liver Function Tests ; Liver Neoplasms/diagnosis/*psychology ; Male ; Middle Aged ; Severity of Illness Index

PURPOSE: Advanced hepatocellular carcinoma (HCC) is associated with various clinical conditions including major vessel invasion, metastasis, and poor performance status. The aim of this study was to establish a prognostic scoring system and to propose a sub-classification of the Barcelona-Clinic Liver Cancer (BCLC) stage C. MATERIALS AND METHODS: This retrospective study included consecutive patients who received sorafenib for BCLC stage C HCC at a single tertiary hospital in Korea. A Cox proportional hazard model was used to develop a scoring system, and internal validationwas performed by a 5-fold cross-validation. The performance of the model in predicting risk was assessed by the area under the curve and the Hosmer-Lemeshow test. RESULTS: A total of 612 BCLC stage C HCC patients were sub- classified into strata depending on their performance status. Five independent prognostic factors (Child-Pugh score, α-fetoprotein, tumor type, extrahepatic metastasis, and portal vein invasion) were identified and used in the prognostic scoring system. This scoring system showed good discrimination (area under the receiver operating characteristic curve, 0.734 to 0.818) and calibration functions (both p < 0.05 by the Hosmer-Lemeshow test at 1 month and 12 months, respectively). The differences in survival among the different risk groups classified by the total score were significant (p < 0.001 by the log-rank test in both the Eastern Cooperative Oncology Group 0 and 1 strata). CONCLUSION: The heterogeneity of patientswith BCLC stage C HCC requires sub-classification of advanced HCC. A prognostic scoring system with five independent factors is useful in predicting the survival of patients with BCLC stage C HCC.
Calibration ; Carcinoma, Hepatocellular* ; Cohort Studies* ; Discrimination (Psychology) ; Humans ; Korea ; Liver Neoplasms ; Neoplasm Metastasis ; Population Characteristics ; Portal Vein ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; ROC Curve ; Tertiary Care Centers

OBJECTIVE: Among the various psychiatric disorders, depression is a common comorbid condition in cancer patients. Due to the distinct and diverse nature of cancer, the prevalence of depression may be assumed to be affected by differences in primary cancer sites. In this study, we explored the prevalence rates of depression among the ten most prevalent cancers in South Korea using a national patient sample. METHODS: This was a 1-year cross-sectional study using a national patient sample provided by the South Korean National Health Insurance in 2011. We selected all patients who had received ICD-10 codes of the 10 most prevalent cancers and major depressive disorder. Afterwards, the cancer and depression groups were merged and analyzed. RESULTS: The MDD prevalence rate was highest in lung cancer (11.0%), followed by non-Hodgkin's lymphoma (9.2%), prostate (9.1%), bladder (8.8%), breast (7.8%), cervix (7.8%), colorectal (7.7%), stomach (6.9%), liver (6.5%), and thyroid cancer (5.6%). Within all cancer groups, patients with a MDD diagnosis were significantly older (p<0.05) than non-MDD patients. Colorectal, stomach, and thyroid cancer displayed a higher female proportion in the MDD group than the non-MDD group. In the subgroup analysis, the prevalence rate differed by age and sex. CONCLUSION: The prevalence of depression varied according to cancer types. Patients with lung cancer were the most prone to experience depression. Because clinical and psychological factors may influence MDD prevalence, these factors will need to be studied more closely in the future.
Breast ; Cervix Uteri ; Cross-Sectional Studies ; Depression* ; Depressive Disorder, Major ; Diagnosis ; Epidemiology ; Female ; Humans ; International Classification of Diseases ; Korea* ; Liver ; Lung Neoplasms ; Lymphoma, Non-Hodgkin ; National Health Programs ; Prevalence* ; Prostate ; Psychology ; Stomach ; Thyroid Neoplasms ; Urinary Bladder

PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.
Activities of Daily Living ; Adult ; Aged ; Asian Continental Ancestry Group ; Attitude to Health ; Communication ; Family Relations ; Female ; *Health Behavior ; Hepatitis B, Chronic/complications/*psychology ; Humans ; Interviews as Topic ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Male ; Middle Aged ; Physician-Patient Relations ; *Qualitative Research ; Republic of Korea