title: Preoperative inflammatory biomarkers and neurovegetative symptoms in peritoneal carcinomatosis patients.
abstract: BACKGROUND
  Inflammation plays a central role in peritoneal carcinomatosis (PC) etiology and progression, and circulating levels of inflammatory biomarkers prior to surgery predict progression-free and overall survival in PC patients. Depression and fatigue are prevalent among PC patients, and experimental research shows that these symptoms may be mediated by proinflammatory cytokines. As yet unstudied is the possibility that the heightened levels of inflammatory markers in PC patients may contribute to their experience of common neurovegetative symptoms.
  
  
  METHODS
  Validated self-report measures of fatigue, depressive symptoms, and quality of life were administered to 64 patients scheduled to undergo aggressive surgical treatment for PC. Serum samples were collected the morning of surgery, and ELISAs were conducted to quantify circulating IL-6, CRP, and TNF-α levels.
  
  
  RESULTS
  Consistent with hypotheses, higher IL-6 levels were associated with more severe fatigue (β=-.39, p<.01) and neurovegetative symptoms of depression (β=.30, p<.05). IL-6 was also related to poorer physical quality of life (β=-.28, p<.05). CRP showed similar significant relationships with fatigue and physical quality of life. Inflammatory biomarkers were not significantly related to emotional symptoms of depression or to emotional or social functioning aspects of quality of life, and TNF-α levels were not related to patient-reported measures.
  
  
  CONCLUSIONS
  Preoperative inflammatory activity may contribute to patients' experiences of fatigue and neurovegetative depressive symptoms as well as impaired quality of life. These biological mechanisms warrant consideration in the clinical management of neurovegetative symptoms in PC patients.
authors.affiliation: University of Pittsburgh Cancer Institute, United States. Electronic address: lowca@upmc.edu.
authors.forename: Carissa A
authors.initials: CA
authors.lastname: Low
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Jenkins
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Ahrendt
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Haroon A
authors.initials: HA
authors.lastname: Choudry
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Holtzman
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Jones
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: James F
authors.initials: JF
authors.lastname: Pingpank
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Lekshmi
authors.initials: L
authors.lastname: Ramalingam
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Herbert J
authors.initials: HJ
authors.lastname: Zeh
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: Amer H
authors.initials: AH
authors.lastname: Zureikat
authors.affiliation: University of Pittsburgh Cancer Institute, United States.
authors.forename: David L
authors.initials: DL
authors.lastname: Bartlett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002277:Carcinoma / Q000097:blood*; D003863:Depression / Q000097:blood*; D005221:Fatigue / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000097:blood*; D057234:Preoperative Period; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Cancer; Cytokines; Depression; Fatigue; Inflammation; Neurovegetative symptoms; Peritoneal carcinomatosis; Quality of life; Sickness behavior