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前列腺癌术后患者焦虑和抑郁的5年随访评估:纵向进展及预后价值

A 5-year follow-up assessment of anxiety and depression in postoperative prostate cancer patients: longitudinal progression and prognostic value.

作者信息

Li Xuexin, Zhang Yuling, Wang Yanjie

机构信息

Department of Urinary Surgery, Cancer Hospital, Harbin Medical University, Harbin, China.

出版信息

Psychol Health Med. 2023 Feb;28(2):529-539. doi: 10.1080/13548506.2022.2115083. Epub 2022 Sep 1.

Abstract

Anxiety and depression are prevalent in cancer patients and correlate with poor prognosis. Nevertheless, their clinical role in prostate cancer patients after tumor resection is limited. Thus, the present study aimed to explore the longitudinal progression of anxiety and depression, and their association with prognosis in these patients. Two hundred and sixty-two prostate cancer patients after tumor resection were enrolled. Hospital Anxiety and Depression Scale (HADS) for anxiety (HADS-A) and for depression (HADS-D), disease-free survival (DFS) and overall survival (OS) were documented during 5-year follow-up. HADS-A score (from 7.73 at baseline to 8.48 at 5 years, = 0.002) and anxiety severity ( = 0.001) but not anxiety rate (from 37.8% at baseline to 45.4% at 5 years, = 0.067) were gradually elevated with time. HADS-D score (from 7.43 at baseline to 8.37 at 5 years, < 0.001), depression rate (from 34.0% at baseline to 46.9% at 5 years, < 0.001) and depression severity ( < 0.001) were also obviously increased with time. Moreover, baseline, 1-year, 2-year, 3-year, 4-year and 5-year anxiety correlated with worse DFS and OS (all < 0.05, except for 2-year anxiety with OS: = 0.126). In addition, baseline, 1-year, 2-year, 3-year, 4-year and 5-year depression associated with worse DFS (all < 0.05); while only baseline, 1-year, 2-year depression related to worse OS (all < 0.05). In conclusion, anxiety and depression continuously aggravate, and associate with poor prognosis in prostate cancer patients after tumor resection, indicating the necessity of proper management of anxiety and depression in these patients.

摘要

焦虑和抑郁在癌症患者中普遍存在,且与预后不良相关。然而,它们在前列腺癌患者肿瘤切除后的临床作用有限。因此,本研究旨在探讨这些患者焦虑和抑郁的纵向进展及其与预后的关系。纳入了262例肿瘤切除后的前列腺癌患者。在5年随访期间记录了用于评估焦虑的医院焦虑抑郁量表(HADS)的焦虑分量表(HADS-A)和抑郁分量表(HADS-D)、无病生存期(DFS)和总生存期(OS)。HADS-A评分(从基线时的7.73升高至5年时的8.48,P = 0.002)和焦虑严重程度(P = 0.001)随时间逐渐升高,但焦虑发生率(从基线时的37.8%升至5年时的45.4%,P = 0.067)未升高。HADS-D评分(从基线时的7.43升高至5年时的8.37,P < 0.001)、抑郁发生率(从基线时的34.0%升至5年时的46.9%,P < 0.001)和抑郁严重程度(P < 0.001)也随时间明显增加。此外,基线、1年、2年、3年、4年和5年时的焦虑与较差的DFS和OS相关(除2年时的焦虑与OS:P = 0.126外,均P < 0.05)。此外,基线、1年、2年、3年、4年和5年时的抑郁与较差的DFS相关(均P < 0.05);而仅基线、1年、2年时的抑郁与较差的OS相关(均P < 0.05)。总之,焦虑和抑郁持续加重,并与前列腺癌患者肿瘤切除后的预后不良相关,表明对这些患者进行焦虑和抑郁适当管理的必要性。

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