Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Sarcoma Center, National Center for Tumor Diseases (NCT/UCC), University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Psychooncology. 2022 Oct;31(10):1700-1710. doi: 10.1002/pon.6009. Epub 2022 Aug 18.
Soft tissue sarcomas (STS) and gastrointestinal stromal tumours (GIST) are a group of rare malignant tumours with a high and heterogenous disease burden. As evidence is scarce, we analysed the prevalence of increased emotional distress and identified distress-associated factors in these patients.
The PROSa-study (Burden and medical care of sarcoma) was conducted between 2017 and 2020 in 39 study centres. Cross-sectional data from adult STS and GIST patients were analysed. Distress was measured with the Patient Health Questionnaire (PHQ-4). The relation of socioeconomic and clinical factors with distress was explored in adjusted logistic regression models.
Among 897 patients, 17% reported elevated anxiety and 19% reported depression. Unemployed patients (odds ratio [OR] 6.6; 95% CI 2.9-15.0), and those with a disability pension (OR 3.1; 95% CI 1.9-5.0) were more likely to experience distress compared to employed patients. Also, patients with a disability pass had higher odds of increased distress than those without (OR 1.8; 95% CI 1.2-2.7). Lowest distress was observed in patients 2 to <5 years and ≥5 years after diagnosis (comparison: <6 months) (OR 0.4; 95% CI 0.2-0.6) and (0.3; 95% CI 0.2-0.6). Patients with thoracic STS (vs. lower limbs) had twice the odds to experience distress (OR 2.0; 95% CI 1.1-3.6). Distress was seen almost twice as often in patients with progressive disease (vs. complete remission) (OR 1.7; 95% CI 1.1-2.8).
The prevalence of elevated distress in STS and GIST patients is high. In unemployed patients, in those with a disability pension and in newly diagnosed patients a noticeable increase was observed. Clinicians should be aware of these factors and consider the social aspects of the disease.
软组织肉瘤(STS)和胃肠道间质瘤(GIST)是一组罕见的恶性肿瘤,疾病负担高且异质性大。由于证据有限,我们分析了这些患者中情绪困扰的发生率,并确定了与困扰相关的因素。
PROSa 研究(肉瘤的负担和医疗)于 2017 年至 2020 年在 39 个研究中心进行。对成年 STS 和 GIST 患者的横断面数据进行了分析。使用患者健康问卷(PHQ-4)测量困扰程度。在调整后的逻辑回归模型中,探索了社会经济和临床因素与困扰的关系。
在 897 名患者中,17%报告存在焦虑升高,19%报告存在抑郁。与就业患者相比,失业患者(比值比 [OR] 6.6;95%置信区间 [CI] 2.9-15.0)和领取残疾抚恤金的患者(OR 3.1;95% CI 1.9-5.0)更有可能出现困扰。此外,与没有残疾证的患者相比,有残疾证的患者出现困扰的几率更高(OR 1.8;95% CI 1.2-2.7)。在诊断后 2 至<5 年和≥5 年的患者中观察到的困扰最低(比较:<6 个月)(OR 0.4;95% CI 0.2-0.6)和(0.3;95% CI 0.2-0.6)。与下肢 STS 相比,胸 STS 患者出现困扰的几率高出两倍(OR 2.0;95% CI 1.1-3.6)。与完全缓解相比,疾病进展患者出现困扰的几率几乎高出两倍(OR 1.7;95% CI 1.1-2.8)。
STS 和 GIST 患者中情绪困扰的发生率较高。在失业患者、领取残疾抚恤金的患者和新诊断的患者中,观察到明显的增加。临床医生应该意识到这些因素,并考虑疾病的社会方面。