{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:57:47Z","timestamp":1792425467027,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["480\u201008\u2010009"],"award-info":[{"award-number":["480\u201008\u2010009"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,12,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Research into the clustering of symptoms may improve the understanding of the underlying mechanisms that affect survivors' symptom burden. This study applied network analyses in a balanced sample of cancer survivors to 1) explore the clustering of symptoms and 2) assess differences in symptom clustering between cancer types, treatment regimens, and short\u2010term and long\u2010term survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used cross\u2010sectional survey data, collected between 2008 and 2018, from the population\u2010based Patient Reported Outcomes Following Initial Treatment and Long Term Evaluation of Survivorship registry, which included survivors of 7 cancer types (colorectal cancer, breast cancer, ovarian cancer, thyroid cancer, chronic lymphocytic leukemia, Hodgkin lymphoma, and non\u2010Hodgkin lymphoma). Regularized partial correlation network analysis was used to explore and visualize the associations between self\u2010reported symptoms (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) and the centrality of these symptoms in the network (ie, how strongly a symptom was connected to other symptoms) for the total sample and for subgroups separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the total sample (n\u00a0=\u00a01330), fatigue was the most central symptom in the network with moderate direct relationships with emotional symptoms, cognitive symptoms, appetite loss, dyspnea, and pain. These relationships persisted after adjustments for sociodemographic and clinical characteristics. Connections between fatigue and emotional symptoms, appetite loss, dyspnea, and pain were consistently found across all cancer types (190 for each), treatment regimens, and short\u2010term and long\u2010term survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a heterogenous sample of cancer survivors, fatigue was consistently the most central symptom in all networks. Although longitudinal data are needed to build a case for the causal nature of these symptoms, cancer survivorship rehabilitation programs could focus on fatigue to reduce the overall symptom burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33852","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T10:59:05Z","timestamp":1628852345000},"page":"4665-4674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["Symptom clusters in 1330 survivors of 7 cancer types from the PROFILES registry: A network analysis"],"prefix":"10.1002","volume":"127","author":[{"given":"Belle H.","family":"de Rooij","sequence":"first","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation Utrecht the Netherlands"},{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1595-7262","authenticated-orcid":false,"given":"Simone","family":"Oerlemans","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrijn","family":"van Deun","sequence":"additional","affiliation":[{"name":"Department of Methodology and Statistics Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floortje","family":"Mols","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation Utrecht the Netherlands"},{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9218-617X","authenticated-orcid":false,"given":"Kelly M.","family":"de Ligt","sequence":"additional","affiliation":[{"name":"Division of Psychosocial Research and Epidemiology Netherlands Cancer Institute Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1387-8686","authenticated-orcid":false,"given":"Olga","family":"Husson","sequence":"additional","affiliation":[{"name":"Division of Psychosocial Research and Epidemiology Netherlands Cancer Institute Amsterdam the Netherlands"},{"name":"Department of Medical Oncology Netherlands Cancer Institute Amsterdam the Netherlands"},{"name":"Division of Clinical Studies Institute of Cancer Research London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5878-4210","authenticated-orcid":false,"given":"Nicole P. M.","family":"Ezendam","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation Utrecht the Netherlands"},{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meeke","family":"Hoedjes","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonneke V.","family":"van de Poll\u2010Franse","sequence":"additional","affiliation":[{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organisation Utrecht the Netherlands"},{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"},{"name":"Division of Psychosocial Research and Epidemiology Netherlands Cancer Institute Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4476-2747","authenticated-orcid":false,"given":"Dounya","family":"Schoormans","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology Tilburg University Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Routes from diagnosis: the most detailed picture of cancer survivorship yet"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2190\/PM.40.2.c"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw253"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2016.08.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-019-00084-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibz019"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2007.01.004"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2010.05.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2012.10.004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2016.08.001"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-010-0865-2"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.10.266"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.2007.145"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2005.05.015"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-010-9757-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002820-200505000-00011"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i04"},{"key":"e_1_2_8_19_1","unstructured":"Van BorkuloCD BoschlooL KossakowskiJ et al.Comparing network structures on three aspects: a permutation test.2017;10. doi:10.13140\/RG.2.2.29455.38569"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050212-185608"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.04.034"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-1979-0"},{"key":"e_1_2_8_23_1","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley JD","year":"2017"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.10.001"},{"key":"e_1_2_8_25_1","first-page":"1860","article-title":"Report of the Committee on Hodgkin's Disease Staging Classification","volume":"31","author":"Carbone PP","year":"1971","journal-title":"Cancer Res"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10993"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.5.365"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1145\/30401.315746"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1037\/met0000167"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/kxm045"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2007.05.060225"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.14.3385"},{"key":"e_1_2_8_33_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1586\/erp.11.55"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0b013e318233a811"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.3248"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05433-3"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/13803390490510905"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1188\/12.ONF.157-165"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-019-02051-3"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0963721416666518"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-005-0899-z"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.15070887"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.33852","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.33852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T21:37:58Z","timestamp":1760305078000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.33852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,13]]},"references-count":42,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2021,12,15]]}},"alternative-id":["10.1002\/cncr.33852"],"URL":"https:\/\/doi.org\/10.1002\/cncr.33852","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,13]]},"assertion":[{"value":"2021-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}