Sanna V, Fedele P, Deiana G, Alicicco MG, Ninniri C, Santoro AN, Pazzola A, Fancellu A. Edmonton Symptom Assessment Scale may reduce medical visits in patients undergoing chemotherapy for breast cancer. World J Clin Oncol 2022; 13(7): 577-586 [PMID: 36157162 DOI: 10.5306/wjco.v13.i7.577]
Corresponding Author of This Article
Alessandro Fancellu, FACS, MD, PhD, Associate Professor, Department of of Medical, Surgical and Experimental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, V.le San Pietro 43, Sassari 07100, Italy. afancel@uniss.it
Research Domain of This Article
Oncology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jul 24, 2022; 13(7): 577-586 Published online Jul 24, 2022. doi: 10.5306/wjco.v13.i7.577
Edmonton Symptom Assessment Scale may reduce medical visits in patients undergoing chemotherapy for breast cancer
Valeria Sanna, Palma Fedele, Giulia Deiana, Maria G Alicicco, Chiara Ninniri, Anna N Santoro, Antonio Pazzola, Alessandro Fancellu
Valeria Sanna, Maria G Alicicco, Antonio Pazzola, Unit of Medical Oncology, A.O.U. Sassari, Sassari 07100, Italy
Palma Fedele, Anna N Santoro, Unit of Medical Oncology, Hospital “D. Camberlingio”, Francavilla Fontana 72100, Brindisi, Italy
Giulia Deiana, Chiara Ninniri, Alessandro Fancellu, Department of Medical, Surgical and Experimental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
Author contributions: Sanna V and Fancellu A designed the study, supervised, wrote and edited the final version; Deiana G, Ninniri C and Alicicco MG provided original data, collected variables, and analysed data; Fedele P and Santoro AN provided technical support, figures, tables, and reviewed the manuscript; Pazzola A envisioned the study, and edited the final manuscript.
Institutional review board statement: This study was approved by A.O.U. (Azienda Ospedaliero-Universitaria) of Sassari Institutional Review Board.
Informed consent statement: All patients enrolled in the study signed an informed consent before chemotherapy treatment.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: Dataset available under reasonable request from the corresponding author at afancel@uniss.it.
STROBE statement: The authors have read the STROBE statement—checklist of items, and the manuscript was prepared and revised according to the STROBE statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alessandro Fancellu, FACS, MD, PhD, Associate Professor, Department of of Medical, Surgical and Experimental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, V.le San Pietro 43, Sassari 07100, Italy. afancel@uniss.it
Received: January 29, 2022 Peer-review started: January 29, 2022 First decision: May 12, 2022 Revised: June 5, 2022 Accepted: June 21, 2022 Article in press: June 21, 2022 Published online: July 24, 2022 Processing time: 174 Days and 2 Hours
ARTICLE HIGHLIGHTS
Research background
Adjuvant chemotherapy (AC) represents a fundamental part of multidisciplinary treatment of women with high-risk breast cancer, since it has been associated to a reduced risk of developing cancer recurrence, as well as to an increased survival. However, no standardised guidelines that regulate the pre-treatment assessment of patients candidates for AC exist. In common practice, a pre-chemotherapy medical visit before every cycle of AC is scheduled, and this represents a time- and resource-demanding practice.
Research motivation
Accurate use of the Edmonton Symptom Assessment Scale (ESAS) may lead to identify patients who do not need to visit a doctor during each course of AC.
Research objectives
To evaluate the value of the ESAS in safely reduce the number of medical visits prior adjuvant chemotherapy.
Research methods
One-hundred breast cancer women candidates to AC were administered the ESAS score (ESAS Group), and were scheduled to receive a total of three medical visits for the entire AC duration. They were prospectively compared to a to a matched-pair group of 100 patients who received adjuvant chemotherapy without ESAS (no-ESAS Group) and were scheduled to receive 16 medical visits for the entire AC duration. Study endpoints were the number of medical visits, occurrence of severe complications, and the number of unplanned visits.
Research results
The mean number of medical visits was 4.38 ± 0.51 in the ESAS Group and 16.18 ± 1.82 in the no-ESAS group (P < 0.001). Unplanned visits during the entire duration of chemotherapy were 8 in the ESAS Group and 18 in the no-ESAS Group visits (P = 0.035). Grade 3-4 toxicity did not differ between the study groups (P = 0.652). Forty-eight patients of the ESAS Group received additional visits due to an ESAS score > 3. With multivariate analysis, women of the ESAS group were more likely to undergo additional visits for an ESAS score > 3 if they were aged 60 or older, received a mastectomy, or had tumour stage II/III.
Research conclusions
Our results suggest that the ESAS score may be used for selecting a group of breast cancer patients for whom it is safe to reduce the number of medical visits in the setting of AC. This may permit a more rational utilization of human resources and a possible reduction of coronavirus pandemic 2019 infection risk in oncologic patients.
Research perspectives
Additional studies are needed to gain new insights into the role of patient-reported outcome strategies in the management of AC in the setting of breast cancer.
