Objective sleep duration (SD) and overall survival (OS) in patients (pts) with metastatic colorectal cancer (MCC).
Bibliographic record
Abstract
511 Background: Sleep is often altered in patients with cancer, with clinical repercussions. Short sleep duration (SD) has been associated with increased risk of earlier death in the general population. The prognostic relevance of SD in cancer pts is unknown. We explored the effect of short ( < 7 hours) SD on the clinical outcomes of pts with MCC before chemotherapy. Methods: Participants were 236 pts with MCC: M/F ratio: 1.66; median age: 60.4 years; range: 21-78; WHO Performance Status (PS) = 0/1/2: 60/34/6%; synchronous metastases: 63%; 2 or more metastatic sites: 55%; prior chemotherapy for metastatic disease: 35%. Pts wore an actigraph for 72 hours before receiving the initial course of an oxaliplatin-based chemotherapy; objective night-time SD was estimated from actigraphy recordings using the Cole-Kripke algorithm. SD was considered short if < 7 hours, based on previous studies. Multivariate Cox proportional Hazard models were built to assess the prognostic value of short SD on OS and progression-free survival (PFS); Binary logistic regression was used to assess the predictive value of short SD for an objective response (OR) or grade 3-4 Toxicity (Tox). Results: Median night SD was 7.4 hours (range: 1.5-10.5). Short SD was observed in 105 (44.5%) pts. Median OS and 3-year survival rate were 14.6 months (mo) [95% C.I.: 11.8-17.4 mo] and 16% [9-23], respectively, in patients with short SD as compared to 16.4 mo [13.0-19.8] and 27% [20-36%] in those with longer SD (p = 0.04). There was no significant difference in PFS (p = 0.25), OR (p = 0.1) or Tox (p = 0.43) rates according to SD. The negative prognostic value of short SD on OS remained significant even after adjustment for age, sex, body mass index, PS, number of metastatic sites, prior chemotherapy and stage at diagnosis (multivariate hazard ratio: 1.45 [1.08-1.93]; p = 0.013). Conclusions: We observed that sleep duration of less than 7 hours before chemotherapy was associated with a significantly shorter survival, independently from other prognostic factors, in pts with MCC. Sufficiently long restorative sleep should be promoted in cancer pts. More research is needed to understand the relationship and mechanisms behind shorter sleep duration and prognosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".