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Diurnal cortisol rhythm as a predictor of lung cancer survival.
Brain Behav Immun. 2013 Mar; 30 Suppl:S163-70.BB

Abstract

BACKGROUND

Poorly coordinated diurnal cortisol and circadian rest-activity rhythms predict earlier mortality in metastatic breast and colorectal cancer, respectively. We examined the prognostic value of the diurnal cortisol rhythm in lung cancer.

METHODS

Lung cancer patients (n=62, 34 female) were within 5 years of diagnosis and had primarily non small-cell lung cancer, with disease stage ranging from early to advanced. Saliva collected over two days allowed calculation of the diurnal cortisol slope and the cortisol awakening response (CAR). Lymphocyte numbers and subsets were measured by flow cytometry. Survival data were obtained for 57 patients. Cox Proportional Hazards analyses were used to test the prognostic value of the diurnal cortisol rhythm on survival calculated both from study entry and from initial diagnosis.

RESULTS

The diurnal cortisol slope predicted subsequent survival over three years. Early mortality occurred among patients with higher slopes, or relatively "flat" rhythms indicating lack of normal diurnal variation (Cox Proportional Hazards p=.009). Cortisol slope also predicted survival time from initial diagnosis (p=.012). Flattened profiles were linked with male gender (t=2.04, df=59, p=.046) and low total and cytotoxic T cell lymphocyte counts (r=-.39 and -.30, p=.004 and .035, respectively). After adjustment for possible confounding factors, diurnal slope remained a significant, independent predictor of survival.

CONCLUSIONS

Flattening of the diurnal cortisol rhythm predicts early lung cancer death. Data contribute to growing evidence that circadian disruption accelerates tumor progression.

Authors+Show Affiliations

Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292-0001, USA. sephton@louisville.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22884416

Citation

Sephton, Sandra E., et al. "Diurnal Cortisol Rhythm as a Predictor of Lung Cancer Survival." Brain, Behavior, and Immunity, vol. 30 Suppl, 2013, pp. S163-70.
Sephton SE, Lush E, Dedert EA, et al. Diurnal cortisol rhythm as a predictor of lung cancer survival. Brain Behav Immun. 2013;30 Suppl:S163-70.
Sephton, S. E., Lush, E., Dedert, E. A., Floyd, A. R., Rebholz, W. N., Dhabhar, F. S., Spiegel, D., & Salmon, P. (2013). Diurnal cortisol rhythm as a predictor of lung cancer survival. Brain, Behavior, and Immunity, 30 Suppl, S163-70. https://doi.org/10.1016/j.bbi.2012.07.019
Sephton SE, et al. Diurnal Cortisol Rhythm as a Predictor of Lung Cancer Survival. Brain Behav Immun. 2013;30 Suppl:S163-70. PubMed PMID: 22884416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diurnal cortisol rhythm as a predictor of lung cancer survival. AU - Sephton,Sandra E, AU - Lush,Elizabeth, AU - Dedert,Eric A, AU - Floyd,Andrea R, AU - Rebholz,Whitney N, AU - Dhabhar,Firdaus S, AU - Spiegel,David, AU - Salmon,Paul, Y1 - 2012/08/03/ PY - 2012/02/16/received PY - 2012/06/30/revised PY - 2012/07/23/accepted PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2013/8/24/medline SP - S163 EP - 70 JF - Brain, behavior, and immunity JO - Brain Behav Immun VL - 30 Suppl N2 - BACKGROUND: Poorly coordinated diurnal cortisol and circadian rest-activity rhythms predict earlier mortality in metastatic breast and colorectal cancer, respectively. We examined the prognostic value of the diurnal cortisol rhythm in lung cancer. METHODS: Lung cancer patients (n=62, 34 female) were within 5 years of diagnosis and had primarily non small-cell lung cancer, with disease stage ranging from early to advanced. Saliva collected over two days allowed calculation of the diurnal cortisol slope and the cortisol awakening response (CAR). Lymphocyte numbers and subsets were measured by flow cytometry. Survival data were obtained for 57 patients. Cox Proportional Hazards analyses were used to test the prognostic value of the diurnal cortisol rhythm on survival calculated both from study entry and from initial diagnosis. RESULTS: The diurnal cortisol slope predicted subsequent survival over three years. Early mortality occurred among patients with higher slopes, or relatively "flat" rhythms indicating lack of normal diurnal variation (Cox Proportional Hazards p=.009). Cortisol slope also predicted survival time from initial diagnosis (p=.012). Flattened profiles were linked with male gender (t=2.04, df=59, p=.046) and low total and cytotoxic T cell lymphocyte counts (r=-.39 and -.30, p=.004 and .035, respectively). After adjustment for possible confounding factors, diurnal slope remained a significant, independent predictor of survival. CONCLUSIONS: Flattening of the diurnal cortisol rhythm predicts early lung cancer death. Data contribute to growing evidence that circadian disruption accelerates tumor progression. SN - 1090-2139 UR - https://www.unboundmedicine.com/medline/citation/22884416/Diurnal_cortisol_rhythm_as_a_predictor_of_lung_cancer_survival_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-1591(12)00202-4 DB - PRIME DP - Unbound Medicine ER -