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软组织肉瘤和胃肠道间质瘤患者的痛苦——一项德国多中心观察性研究(PROSa)的结果。

Distress in soft-tissue sarcoma and gastrointestinal stromal tumours patients-Results of a German multicentre observational study (PROSa).

机构信息

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.

出版信息

Psychooncology. 2022 Oct;31(10):1700-1710. doi: 10.1002/pon.6009. Epub 2022 Aug 18.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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