Anna Wikman1, Rickard Ljung2, Asif Johar2, Ylva Hellstadius2, Jesper Lagergren2, Pernilla Lagergren2. 1. All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom. anna.wikman@ki.se. 2. All authors, Karolinska Institutet, Stockholm, Sweden; and Jesper Lagergren, King's College London, London, United Kingdom.
Abstract
PURPOSE: To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer. PATIENTS AND METHODS: A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival. RESULTS: In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs). CONCLUSION: These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.
PURPOSE: To determine the cumulative incidence of and risk factors for psychiatric morbidity and establish the impact on survival among surgically treated patients with esophageal cancer. PATIENTS AND METHODS: A nationwide Swedish cohort of 1,615 patients who underwent surgery for esophageal cancer between 1987 and 2010 with follow-up until 2012 was linked to national health registries for information on psychiatric morbidity (inferred from mental health care use). Multivariable logistic regressions were used to determine potential risk factors for postoperative psychiatric morbidity. A multivariable-adjusted Cox proportional hazard model was used to analyze overall survival. RESULTS: In patients without a history of psychiatric morbidity, the 2-year cumulative incidence for treatment in psychiatric in-patient care was 2.5%, for psychiatric out-patient care was 4.2%, and for treatment with psychotropic drugs was 32.3%. Married patients were less likely to be treated postoperatively in psychiatric in-patient care (odds ratio [OR], 0.42; 95% CI, 0.22 to 0.80) or out-patient care (OR, 0.41; 95% CI, 0.17 to 1.02), whereas patients with higher tumor stage were more likely to be treated in psychiatric out-patient care (OR, 4.99; 95% CI, 1.16 to 21.38) or with psychotropic drugs (OR, 2.78; 95% CI, 1.10 to 7.01). Bearing in mind possible residual confounding, new-onset psychiatric morbidity was associated with mortality (hazard ratio [HR], 1.65 [95% CI, 1.17 to 2.33] for treatment in psychiatric in-patient care; HR, 1.93 [95% CI, 1.18 to 3.16] for treatment in psychiatric out-patient care; and HR, 2.77 [95% CI, 1.72 to 4.44] for treatment with psychotropic drugs). CONCLUSION: These results highlight the importance of recognizing and addressing psychiatric morbidity in surgically treated patients with esophageal cancer.
Authors: Sheraz R Markar; Stella Mavroveli; Konstantinos V Petrides; Marco Scarpa; Veronique Christophe; Carlo Castoro; Christophe Mariette; Pernilla Lagergren; George B Hanna Journal: BMJ Open Date: 2016-10-24 Impact factor: 2.692
Authors: Yangjun Liu; Erik Pettersson; Anna Schandl; Sheraz Markar; Asif Johar; Pernilla Lagergren Journal: Support Care Cancer Date: 2022-08-11 Impact factor: 3.359