Emotional functioning to screen for psychological distress in breast and colorectal cancer patients prior to adjuvant treatment initiation.

INTRODUCTION: The objective was to analyze the usefulness of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) EF subscale to detect emotional problems in patients with breast (BC) and colorectal cancer (CRC). METHODS: A prospective, observational, cross-sectional study was conducted. Participants completed the Brief Symptom Inventory (BSI) and EORTC-QLQ-C30. The following psychometric properties were calculated: accuracy, sensitivity, positive predictive value, specificity and negative predictive value. RESULTS: The sample analyzed included 445 patients: 202 with BC and 243 with CRC. In total, 129 BC patients (64%) and 104 CRC patients (43%) suffered psychological distress according to the BSI. The accuracy of EORTC-QLQ-C30 EF in detecting psychological distress was 77% and 82% in BC and CRC respectively. Specificity rates for BC and CRC were 81% and 82%, and sensitivity was 75% and 82% respectively. Positive predictive value was 87% and 77%, and negative predictive value was 65% and 86% in BC and CRC respectively. The mean AUC for BC was 0.83 and 0.88 for CRC. CONCLUSIONS: The EORTC-QLQ-C30 EF is useful for rapid screening. The systematic application of this scale would allow patients with cancer and emotional problems to be easily identified in clinical practice.

Histology-dependent prognostic role of pERK and p53 protein levels in early-stage non-small cell lung cancer.

Lung tumors represent a major health problem. In early stage NSCLC tumors, surgical resection is the preferred treatment, but 30-55% of patients will relapse within 5 years after surgery. Thus, the identification of prognostic biomarkers in early stage NSCLC patients, especially those which are therapeutically addressable, is crucial to enhance survival of these patients. We determined the immunohistochemistry expression of key proteins involved in tumorigenesis and oncogenic signaling, p53, EGFR, pAKT and pERK, and correlated their expression level to clinicopathological characteristics and patient outcome. We found EGFR expression is higher in the squamous cell carcinomas than in adenocarcinomas (p=0.043), and that nuclear p53 staining correlated with lower differentiated squamous tumors (p=0.034). Regarding the prognostic potential of the expression of these proteins, high pERK levels proved to be an independent prognostic factor for overall (p<0.001) and progression-free survival (p<0.001) in adenocarcinoma patients, but not in those from the squamous histology, and high p53 nuclear levels were identified as independent prognostic factor for progression-free survival (p=0.031) only in squamous cell carcinoma patients. We propose a role as early prognostic biomarkers for pERK protein levels in adenocarcinoma, and for nuclear p53 levels in squamous cell lung carcinoma. The determination of these potential biomarkers in the adequate histologic context may predict the outcome of early stage NSCLC patients, and may offer a therapeutic opportunity to enhance survival of these patients.