Hellstadius Ylva, Lagergren Pernilla, Lagergren Jesper, Johar Asif, Hultman Christina M, Wikman Anna
Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Psychooncology. 2015 Jan;24(1):47-53. doi: 10.1002/pon.3583. Epub 2014 Jun 3.
The aim of this study was to establish the proportion of patients reporting emotional problems following oesophagectomy for cancer and identify the risk characteristics for emotional problems.
A Swedish population-based cohort study of patients with surgically treated oesophageal cancer was used. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was used to assess tension, worry, irritation and depressed mood at 6 months and 5 years after surgery. Potential risk characteristics were retrieved from medical notes and data linkages to Swedish health registries. Multivariable logistic regression analyses were performed to examine risk characteristics for poor emotional recovery.
Of 401 patients included at 6 months, 49% reported problems with tension, 61% worry, 62% irritation and 63% depressed mood. Of the 140 (35%) patients who completed the 5-year follow-up, 39% reported problems with tension and about half of the patients reported problems with worry, irritation, and depressed mood (49, 45 and 52%, respectively). Squamous cell carcinoma was identified as a risk characteristic for tension (OR 2.15, 95% CI 1.30-3.55), worry (OR 2.02, 95% CI 1.19-3.40) and depressed mood (OR 1.71, 95% CI 1.01-2.90) at 6 months compared with adenocarcinoma. Compared with higher education, lower education was associated with tension (upper secondary schooling: OR 1.97, 95% CI 1.02-3.79 and 9-year compulsory: OR 2.46, 95% CI 1.28-4.74), while non-cohabitating patients were less likely to report problems with worry at 6 months (OR 0.53, 95% CI 0.34-0.84) compared with cohabitating patients.
A substantial proportion of patients reports emotional problems following oesophagectomy, and risk characteristics include squamous cell carcinoma histology and low educational level.
本研究旨在确定食管癌切除术后报告有情绪问题的患者比例，并识别情绪问题的风险特征。
采用一项基于瑞典人群的食管癌手术患者队列研究。使用欧洲癌症研究与治疗组织生活质量问卷C30评估术后6个月和5年时的紧张、担忧、易怒和情绪低落情况。从病历和与瑞典健康登记处的数据关联中获取潜在的风险特征。进行多变量逻辑回归分析以检查情绪恢复不良的风险特征。
在6个月时纳入的401例患者中，49%报告有紧张问题，61%有担忧问题，62%有易怒问题，63%有情绪低落问题。在完成5年随访的140例（35%）患者中，39%报告有紧张问题，约一半患者报告有担忧、易怒和情绪低落问题（分别为49%、45%和52%）。与腺癌相比，鳞状细胞癌被确定为术后6个月时紧张（比值比2.15，95%置信区间1.30 - 3.55）、担忧（比值比2.02，95%置信区间1.19 - 3.40）和情绪低落（比值比1.71，95%置信区间1.01 - 2.90）的风险特征。与高等教育相比，低教育水平与紧张相关（高中教育：比值比1.97，95%置信区间1.02 - 3.79；9年义务教育：比值比2.46，95%置信区间1.28 - 4.74），而与同居患者相比，非同居患者在6个月时报告担忧问题的可能性较小（比值比0.53，95%置信区间0.34 - 0.84）。
相当一部分患者在食管癌切除术后报告有情绪问题，风险特征包括鳞状细胞癌组织学类型和低教育水平。
