Burnet Katriina L, Parker Chris, Dearnaley David, Brewin Chris R, Watson Maggie
Psychological Medicine, Royal Marsden NHS Foundation Trust, London, UK.
BJU Int. 2007 Sep;100(3):540-3. doi: 10.1111/j.1464-410X.2007.07009.x. Epub 2007 Jun 5.
To investigate, in a cross-sectional study, the prevalence of anxiety and depression in patients with localised prostate cancer managed by active surveillance, compared with those receiving immediate treatment, as active surveillance is a relatively new approach to managing this disease, designed to avoid 'unnecessary' treatment, but it is unclear whether the approach contributes to psychological distress, given that men are living with untreated cancer.
A consecutive series of 764 patients with prostate cancer were approached in outpatient clinics. Of these, 329 men with localized disease (cT1/2, N0/NX, M0/MX) meeting the study entry criteria, completed the Hospital Anxiety and Depression Scale (HADS); 100 were on active surveillance, 81 were currently receiving radical treatment (radiotherapy + neoadjuvant hormone therapy) and 148 had previously received radical radiotherapy.
Overall, 16% (51/329) of patients met the HADS criteria for anxiety and 6% (20/329) for depression. Analyses indicated that higher anxiety scores were significantly associated with younger age (P < 0.01) and a longer interval since diagnosis (P < 0.01), but not with management by active surveillance (P = 0.38). Higher depression scores were significantly associated with a longer interval since diagnosis (P < 0.05), but not with management by active surveillance (P = 0.83).
Active surveillance for managing localized prostate cancer was not associated with greater psychological distress than more immediate treatment for prostate cancer.
在一项横断面研究中，调查接受主动监测的局限性前列腺癌患者与接受立即治疗的患者相比焦虑和抑郁的患病率。由于主动监测是一种相对较新的管理该疾病的方法，旨在避免“不必要的”治疗，但鉴于男性患有未经治疗的癌症，尚不清楚这种方法是否会导致心理困扰。
在门诊对连续的764例前列腺癌患者进行了研究。其中，329例符合研究纳入标准的局限性疾病（cT1/2，N0/NX，M0/MX）男性患者完成了医院焦虑抑郁量表（HADS）；100例接受主动监测，81例目前正在接受根治性治疗（放疗+新辅助激素治疗），148例既往接受过根治性放疗。
总体而言，16%（51/329）的患者符合HADS焦虑标准，6%（20/329）符合抑郁标准。分析表明，较高的焦虑评分与较年轻的年龄（P<0.01）和诊断后较长的时间间隔（P<0.01）显著相关，但与主动监测管理无关（P=0.38）。较高的抑郁评分与诊断后较长的时间间隔显著相关（P<0.05），但与主动监测管理无关（P=0.83）。
与更直接的前列腺癌治疗相比，主动监测局限性前列腺癌与更大的心理困扰无关。
