In this study, we sought to explore the prevalence of depression and fatigue in colorectal cancer patients during and after treatment to examine how these variables affect quality of life (QoL). In total, 170 patients with colorectal cancer participated in this study. The study population was divided into two groups: one receiving treatment and another that had finished treatment. The results showed that depression and fatigue measurements were higher in patients receiving treatment. Depression was a strong and significant predictor of QoL in both groups, whereas fatigue was not, with the exception of the symptom score. These findings underscore the importance of early detection and management of depression and fatigue during the treatment and survival stages of patients with colorectal cancer. Our findings indicate that health care professionals should provide appropriate nursing intervention to decrease depression and fatigue and enhance patient QoL.

Background: Colorectal cancer is one of the most common malignancies in developed countries. The incidence of colorectal cancer (CRC) in Taiwan is rising. We aimed to determine the five-yr survival rate of patients diagnosed with CRC and determine factors affecting survival. Methods: All patients were identified from the Taiwan Cancer Data Base of the Medical Center Hospital in North Taiwan from 2007 to 2013. Data were collected using medical records and the cancer database. In all, 869 patients with CRC were included. Survival analysis was performed using Kaplan-Meier curves, and differences between the curves were analyzed using the log-rank test. Cox proportional hazards regression models were used to analyze survival by each variable. Results: The five-yr survival rate and the mean survival time after cancer diagnosis were 68.7% and 71.27 +/- 1.27 months. Perineural nerve invasion, distant metastasis, age, pathological differentiation grade, obstruction and regional lymph node metastasis were found to be independent predictors of the survival and prognosis of patients with CRC. Conclusion: Perineural nerve invasion was an important factor related to the survival of CRC patients. Thus, the earlier detection of CRC might help improve survival.

Introduction Colorectal cancer (CRC) is rapidly increasing in developed countries. In Taiwan, the incidence rate of CRC has increased during the past decade, but the 5-year survival has remained at approximately 63%. In this study, we sought to determine the five-year survival rate of patients...

Objective: The purpose of this study was to explore the pathways among the practice environment, job burnout, and job satisfaction and their relationships with the intention to leave among clinical nurses. Method: A cross-sectional survey was administered to 310 nursing staff members working in regional teaching hospitals in southern Taiwan. The instruments used included the practice environment, job satisfaction, job burnout, and sociodemographic characteristics questionnaires. Results: Structural equation modeling indicated that job satisfaction (β = –0.167) and job burnout (β = 0.361) were significantly and directly associated with the intention to leave, whereas the practice environment was significantly and directly associated with job satisfaction (β = 0.447). The practice environment (βindirect = –0.075) and job burnout (βindirect = 0.060) were significantly and indirectly associated with the intention to leave through job satisfaction. Conclusion: Job burnout and job satisfaction are directly associated with the intention to leave. Therefore, improving the practice environment and subsequent job burnout could be strategies to improve job satisfaction and decrease the intention to leave.

Background: Metabolic bariatric surgery (MBS) yields significant but heterogeneous recovery patterns. The longitudinal interplay between evolving eating behaviors and health-related quality of life (HRQoL) remains insufficiently characterized. Objectives: To identify trajectories of eating behavior and HRQoL during the first postoperative year and examine their associations with 12-month outcomes. Methods: A total of 244 patients from two hospitals in Taiwan were followed for 12 months. Dutch Eating Behavior Questionnaire, and Impact of Weight on Quality of Life-Lite were assessed. Group-based trajectory modeling (GBTM) identified latent subgroups, and multiple regression analyzed associations with 12-month HRQoL, adjusting for clinical covariates. Results: GBTM identified two distinct trajectories for restrained, emotional, and external eating. For HRQoL, three trajectories emerged: high-start stable (45–50%), moderate-decline (30–35%), and low-start improving (~20%). In the regression model (R² = 0.37, p < 0.001), eating behavior trajectories were not independently associated with total HRQoL at 12 months after adjusting for covariates, including baseline BMI and comorbidities. Specifically, restrained eating (β = −1.42, p = 0.502), emotional eating (β = −10.33, p = 0.110), and external eating (β = −5.33, p = 0.160) trajectories did not significantly predict global HRQoL scores. Conclusions: Postoperative adaptation is characterized by substantial heterogeneity, with a significant subgroup experiencing HRQoL decline despite surgery. While eating behavior trajectories align with domain-specific psychosocial trends, early postoperative clinical factors appear to exert a more dominant influence on total HRQoL during the first year. These findings suggest that multidisciplinary support should target specific vulnerable trajectories to optimize long-term outcomes.

Urothelial carcinoma (UC) carcinogenesis has been hypothesized to occur through epigenetic repression of tumor suppressor genes (TSGs). By qRT-PCR array, we found that one potential TSG, ANGPTL4, was expressed at very low levels in all UC cell lines we examined. Previous studies had demonstrated that ANGPTL4 is highly expressed in some cancers, but downregulated, by DNA methylation, in others. Consequently, due to these seemingly conflicting functions in distinct cancers, the precise role of ANGPTL4 in the etiology of UC remains unclear. In this study, using methylation-specific PCR and bisulfite pyrosequencing, we show that ANGPTL4 is transcriptionally repressed by promoter hypermethylation in UC cell lines and primary tumor samples, as compared to adjacent noncancerous bladder urothelium. Functional studies further demonstrated that ectopic expression of ANGPTL4 potently suppressed UC cell proliferation, monolayer colony formation in vitro, and invasion, migration, and xenograft formation in vivo. As ANGPTL4 is a secreted factor, we therefore examined the circulating ANGPTL4 (cir-ANGPTL4) level in UC patients. Surprisingly, cir-ANGPTL4 was significantly higher in plasma samples from UC patients than normal control, suggesting it might be secreted from other cell types. More importantly, exogenous c-terminal fragment of ANGPTL4 (cANGPTL4) could promote cell proliferation and cell migration via activation of signaling through the Erk/FAK axis. We further confirmed that mouse xenograft tumor growth could be promoted by administration of exogenous cANGPTL4. Finally, immunohistochemistry demonstrated that ANGPTL4 was downregulated in tumor cells but overexpressed in tumor-adjacent stromal tissues including muscle and macrophages of muscle-invasive UC tissue samples. In conclusion, our data supports dual roles for ANGPTL4 in urothelial carcinoma progression, either as a tumor suppressor or oncogene, in response to microenvironmental context. Citation Format: Michael WY Chan, Hsiao-Yen Hsieh, Yeong-Chin Jou, Chun-Liang Tung, Yuh-Shyan Tsai, Yuan-Hung Wang, Chen-Lin Chi, Ru-Inn Lin, Shih-Kai Hung, Yu-Ming Chuang, Shu-Fen Wu, Chin Li, Cheng-Huang Shen, Cheng-Da Hsu. Epigenetic silencing of ANGPTL4 in tumor tissues and its overexpression in the urothelial carcinoma microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5339.