Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Departments of Mathematics and Life Science Systems, Technical University of Munich, Garching, Germany.
Cancer. 2021 Nov 15;127(22):4287-4295. doi: 10.1002/cncr.33836. Epub 2021 Aug 6.
Although fear of cancer recurrence (FCR) or disease progression is among the most endorsed unmet needs and concerns of cancer survivors, research on the course of FCR in long-term survivors is scarce. The objective of this study was to assess longitudinally the prevalence and predictors of FCR in long-term prostate cancer (PCa) survivors.
In all, 2417 survivors from the multicenter German Familial Prostate Cancer Database completed the Fear of Progression Questionnaire-Short Form on average 7 years (T1 in 2010) after radical prostatectomy and at follow-up 9 years later (T2 in 2019). Hierarchical multivariable logistic regression was used to assess predictors of FCR at follow-up.
The mean age at the initial assessment was 69.5 years (standard deviation, 5.9 years); 6.5% and 8.4% of patients reported clinical FCR at the initial assessment (T1) and at the follow-up (T2), respectively. In a multivariable analysis controlling for concurrent associations, longitudinal predictors of FCR 9 years later included a lower level of education (odds ratio [OR], 4.35; 95% confidence interval [CI], 2.33-8.33), years since radical prostatectomy (OR, 1.10; 95% CI, 1.03-1.18), biochemical recurrence (OR, 1.67; 95% CI, 1.02-2.72), no current adjuvant therapy (OR, 2.38; 95% CI, 1.19-4.76), FCR (OR, 10.75; 95% CI, 6.18-18.72), and anxiety (OR, 1.35; 95% CI, 1.06-1.72).
FCR remains a burden to certain PCa survivors even many years after their diagnosis and treatment. Health care professionals should monitor for FCR and identify patients at risk to provide appropriate psychosocial care because FCR is leading to limitations in quality of life and psychological well-being.
尽管对癌症复发（FCR）或疾病进展的恐惧是癌症幸存者最认可的未满足需求和关注点之一，但对长期幸存者中 FCR 病程的研究却很少。本研究的目的是纵向评估长期前列腺癌（PCa）幸存者中 FCR 的流行率和预测因素。
总共，2417 名来自多中心德国家族性前列腺癌数据库的幸存者在根治性前列腺切除术后平均 7 年（T1 在 2010 年）时完成了简短形式的恐惧进展问卷，并在 9 年后的随访中完成（T2 在 2019 年）。使用分层多变量逻辑回归评估随访时 FCR 的预测因素。
初始评估时的平均年龄为 69.5 岁（标准差为 5.9 岁）；分别有 6.5%和 8.4%的患者在初始评估（T1）和随访（T2）时报告临床 FCR。在控制同期关联的多变量分析中，9 年后 FCR 的纵向预测因素包括较低的教育水平（优势比[OR]，4.35；95%置信区间[CI]，2.33-8.33）、根治性前列腺切除术后年限（OR，1.10；95%CI，1.03-1.18）、生化复发（OR，1.67；95%CI，1.02-2.72）、当前无辅助治疗（OR，2.38；95%CI，1.19-4.76）、FCR（OR，10.75；95%CI，6.18-18.72）和焦虑（OR，1.35；95%CI，1.06-1.72）。
即使在诊断和治疗多年后，FCR 仍然是某些 PCa 幸存者的负担。医疗保健专业人员应监测 FCR 并识别处于风险中的患者，以提供适当的社会心理护理，因为 FCR 会导致生活质量和心理健康受限。
