{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:13:46Z","timestamp":1778562826144,"version":"3.51.4"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Outpatient palliative care effectively alleviates symptom burden in advanced cancer patients, yet data from Central\u2013Eastern Europe remain scarce. This retrospective study examined changes in revised Edmonton Symptom Assessment Scale (ESAS) scores from initial outpatient palliative consultation to first follow-up in Hungarian cancer patients, assessing clinically meaningful improvement and inter-symptom associations. Methods: Revised ESAS scores from 119 patients attending an outpatient palliative care clinic (2017\u20132020) were analyzed using paired baseline and first follow-up assessments (7\u201330 days). Symptom changes (Time 2\u2013Time 1) were evaluated using Wilcoxon signed-rank tests. Clinically meaningful improvement was assessed with minimal clinically important difference thresholds (0.5\u00d7 baseline SD). Sankey diagrams visualized symptom transitions, and multivariable linear regression examined inter-symptom associations. Results: Baseline pain was highest (mean 6.29, median 7), followed by fatigue, sleep disorder, and impaired well-being. At follow-up, significant reductions were observed in pain (mean 4.52, p = 0.001), nausea, dyspnea, constipation, sleep disorder, depression, and anxiety (all p &lt; 0.05). Sankey diagrams showed shifts from severe to mild\/moderate pain (50% to 24%) and constipation. Clinically meaningful improvement occurred in pain, nausea, and constipation, with 59\u201365% achieving \u22651-point pain reduction. Regression analyses showed that pain reduction was associated with concurrent improvements in sleep disorder (\u03b2 = 0.31), depression (\u03b2 = 0.20), fatigue (\u03b2 = 0.20), and anxiety (\u03b2 = 0.14), while dyspnea reduction was associated with concurrent improvements in depression (\u03b2 = 0.22) and anxiety (\u03b2 = 0.14). Conclusions: Outpatient palliative care in Hungarian cancer patients resulted in clinically meaningful symptom reductions, particularly pain and dyspnea. Improvements in these core symptoms were associated with concurrent improvements in other symptom domains, underscoring the clinical relevance of inter-symptom associations and supporting early, integrated outpatient palliative care and symptom cluster-based management.<\/jats:p>","DOI":"10.3390\/jcm15093532","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:36:23Z","timestamp":1778052983000},"page":"3532","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom Improvement and Interrelated ESAS Domains Following Outpatient Palliative Care in Hungarian Cancer Patients"],"prefix":"10.3390","volume":"15","author":[{"given":"N\u00f3ra","family":"Frank","sequence":"first","affiliation":[{"name":"Department of Hospice-Palliative Care, Department of Primary Health Care, University of P\u00e9cs Medical School, R\u00e1k\u00f3czi Street 2, 7623 P\u00e9cs, Hungary"},{"name":"Faculty of Health Sciences, Doctoral School of Health Sciences, University of P\u00e9cs, Szepesy Ign\u00e1c Street 1\u20133, 7621 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6916-1118","authenticated-orcid":false,"given":"Csilla","family":"Busa","sequence":"additional","affiliation":[{"name":"Department of Hospice-Palliative Care, Department of Primary Health Care, University of P\u00e9cs Medical School, R\u00e1k\u00f3czi Street 2, 7623 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eszter","family":"S\u00e1ghy","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, University of P\u00e9cs, R\u00f3kus Street 2, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Pozsgai","sequence":"additional","affiliation":[{"name":"Department of Hospice-Palliative Care, Department of Primary Health Care, University of P\u00e9cs Medical School, R\u00e1k\u00f3czi Street 2, 7623 P\u00e9cs, Hungary"},{"name":"Department of Public Health Medicine, University of P\u00e9cs Medical School, Szigeti Street 12, 7624 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3322-9122","authenticated-orcid":false,"given":"\u00c1gnes","family":"Csik\u00f3s","sequence":"additional","affiliation":[{"name":"Department of Hospice-Palliative Care, Department of Primary Health Care, University of P\u00e9cs Medical School, R\u00e1k\u00f3czi Street 2, 7623 P\u00e9cs, Hungary"},{"name":"Faculty of Health Sciences, Doctoral School of Health Sciences, University of P\u00e9cs, Szepesy Ign\u00e1c Street 1\u20133, 7621 P\u00e9cs, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jpainsymman.2020.04.027","article-title":"Redefining Palliative Care\u2014A New Consensus-Based Definition","volume":"60","author":"Radbruch","year":"2020","journal-title":"J. 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