Ylva Hellstadius1, Jesper Lagergren2,3,4, Janine Zylstra3,4, James Gossage2,3,4, Andrew Davies2,3,4, Christina M Hultman5, Pernilla Lagergren1,3, Anna Wikman6. 1. a Department of Molecular Medicine and Surgery, Surgical Care Science , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden. 2. b Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery , Karolinska Institutet , Stockholm , Sweden. 3. c Division of Cancer Studies , King's College London , London , UK. 4. d Guy's and St Thomas' NHS Foundation Trust , London , UK. 5. e Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden. 6. f Department of Women's and Children's Health, Clinical Psychology in Healthcare , Uppsala University , Uppsala , Sweden.
Abstract
BACKGROUND: Psychological distress is common among patients with oesophageal cancer. However, little is known about the course and predictors of psychological distress among patients treated with curative intent. Therefore, the aim of this study was to explore the prevalence, course and predictors of anxiety and depression in patients operated for oesophageal cancer, from prior to surgery to 12 months post-operatively. METHODS: A prospective cohort of patients with oesophageal cancer (n = 218) were recruited from one high-volume specialist oesophago-gastric treatment centre (St Thomas' Hospital, London, UK). Anxiety and depression were assessed prior to surgery, 6 and 12 months post-operatively. Mixed-effects modelling was performed to investigate changes over time and to estimate the association between clinical and socio-demographic predictor variables and anxiety and depression symptoms. RESULTS: The proportion of patients with anxiety was 33% prior to surgery, 28% at 6 months, and 37% at 12 months. Prior to surgery, 20% reported depression, 27% at 6 months, and 32% at 12-month follow-up. Anxiety symptoms remained stable over time whereas depression symptoms appeared to increase from pre-surgery to 6 months, levelling off between 6 and 12 months. Younger age, female sex, living alone and more severe self-reported dysphagia (i.e., difficulty swallowing) predicted higher anxiety symptoms. In-hospital complications, greater limitations in activity status and more severe self-reported dysphagia were predictive of higher depression. CONCLUSIONS: Many patients report psychological distress during the first year following oesophageal cancer surgery. Whether improving the experience of swallowing difficulties may also reduce distress among these patients warrants further study.
BACKGROUND: Psychological distress is common among patients with oesophageal cancer. However, little is known about the course and predictors of psychological distress among patients treated with curative intent. Therefore, the aim of this study was to explore the prevalence, course and predictors of anxiety and depression in patients operated for oesophageal cancer, from prior to surgery to 12 months post-operatively. METHODS: A prospective cohort of patients with oesophageal cancer (n = 218) were recruited from one high-volume specialist oesophago-gastric treatment centre (St Thomas' Hospital, London, UK). Anxiety and depression were assessed prior to surgery, 6 and 12 months post-operatively. Mixed-effects modelling was performed to investigate changes over time and to estimate the association between clinical and socio-demographic predictor variables and anxiety and depression symptoms. RESULTS: The proportion of patients with anxiety was 33% prior to surgery, 28% at 6 months, and 37% at 12 months. Prior to surgery, 20% reported depression, 27% at 6 months, and 32% at 12-month follow-up. Anxiety symptoms remained stable over time whereas depression symptoms appeared to increase from pre-surgery to 6 months, levelling off between 6 and 12 months. Younger age, female sex, living alone and more severe self-reported dysphagia (i.e., difficulty swallowing) predicted higher anxiety symptoms. In-hospital complications, greater limitations in activity status and more severe self-reported dysphagia were predictive of higher depression. CONCLUSIONS: Many patients report psychological distress during the first year following oesophageal cancer surgery. Whether improving the experience of swallowing difficulties may also reduce distress among these patients warrants further study.
Authors: Yangjun Liu; Erik Pettersson; Anna Schandl; Sheraz Markar; Asif Johar; Pernilla Lagergren Journal: Support Care Cancer Date: 2021-09-04 Impact factor: 3.359
Authors: Eida M Castro-Figueroa; Normarie Torres-Blasco; Milagros C Rosal; Julio C Jiménez; Wallesca P Castro-Rodríguez; Marilis González-Lorenzo; Héctor Vélez-Cortés; Alia Toro-Bahamonde; Rosario Costas-Muñiz; Guillermo N Armaiz-Peña; Heather Jim Journal: Nurs Rep Date: 2021-06-09