Midenberg Eric R, Schmeusser Benjamin N, Palacios Arnold, Larsen Kristin, Patil Dattatraya H, Petrinec Ben, Croll Ben, Le Thien-Linh, Hong Gordon, Lin Fangyi Rose, Jesson Kaleena, Lee Grace, Kwon Frances Y, Ogan Kenneth, Master Viraj A
Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Transl Androl Urol. 2022 Nov;11(11):1503-1511. doi: 10.21037/tau-22-408.
Quantifying grit with the Short Grit Scale (Grit-S) has shown ability to predict success in various academic and professional domains. Grit has yet to be analyzed in patients with cancer.
This study is a longitudinal analysis of prospectively distributed Grit-S surveys to patients undergoing radical or partial nephrectomy. Patients who completed a preoperative Grit-S survey with confirmed renal cell carcinoma (RCC) were included in the analysis. The relationship between preoperative grit scores and overall survival (OS) was determined using Cox proportional-hazard models and Kaplan-Meier analysis.
A total of 323 patients with RCC that completed the Grit-S survey prior to nephrectomy were included in the study. Median Grit score was 3.9. Most patients were male (67.5%), White (69.3%), and greater than 60 years old (57.0%) with a median age of 62 at the time of surgery. Patients scoring above or below the median grit score had similar baseline characteristics. As a binary variable, lower preoperative grit was significantly associated with shorter OS [hazard ratio (HR) =2.02, 95% confidence interval (CI): 1.12-3.63, P=0.019] on multivariable analysis. Unit changes in grit were not significantly associated with OS (HR =0.77, 95% CI: 0.53-1.14, P=0.193).
Lower grit scores may predict decreased OS in RCC patients undergoing nephrectomy. The Grit-S survey may have utility in preoperative evaluation. Further research assessing grit in other malignancies and how to psychologically optimize patients prior to surgery are needed.
使用简短坚毅量表（Grit-S）对坚毅进行量化已显示出能够预测在各个学术和专业领域取得成功的能力。尚未对癌症患者的坚毅进行分析。
本研究是对前瞻性分发给接受根治性或部分肾切除术患者的Grit-S调查问卷进行的纵向分析。分析纳入了完成术前Grit-S调查问卷且确诊为肾细胞癌（RCC）的患者。使用Cox比例风险模型和Kaplan-Meier分析确定术前坚毅得分与总生存期（OS）之间的关系。
共有323例在肾切除术前完成Grit-S调查问卷的RCC患者纳入研究。坚毅得分中位数为3.9。大多数患者为男性（67.5%）、白人（69.3%），年龄大于60岁（57.0%），手术时中位年龄为62岁。坚毅得分高于或低于中位数的患者具有相似的基线特征。作为二元变量，多变量分析显示术前较低的坚毅水平与较短的OS显著相关[风险比（HR）=2.02，95%置信区间（CI）：1.12 - 3.63，P = 0.019]。坚毅得分的单位变化与OS无显著相关性（HR = 0.77，95% CI：0.53 - 1.14，P = 0.193）。
较低的坚毅得分可能预示着接受肾切除术的RCC患者的OS降低。Grit-S调查问卷可能在术前评估中有用。需要进一步研究评估其他恶性肿瘤中的坚毅情况以及如何在手术前对患者进行心理优化。
