Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, 41345, Gothenburg, Sweden.
Department of Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Arch Gynecol Obstet. 2023 Aug;308(2):515-525. doi: 10.1007/s00404-023-06917-w. Epub 2023 Jan 25.
This study aimed to explore how patients treated for endometrial cancer (EC) with robotic surgery are affected in symptoms of anxiety and depression and HRQoL in the long term.
Women scheduled for primary robotic surgery for EC were included (n = 64), in this single-center study. Socioeconomic variables were obtained at baseline. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire Core 30 (QLQ-C30), its module for EC (EN24), the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire Depression Scale (PHQ-9) were followed prospectively from baseline to 2 weeks, 3 months and 1 year postoperatively.
The number of patients scoring above the clinical threshold for anxiety decreased from 17 (27.0%) at baseline to 4 (7.0%) at 2 weeks (p = 0.012). Depressive symptoms were reported in 20% of patients at baseline and did not change significantly during the one-year follow-up (p = 0.58). A significant decrease in Global health status was seen at 2 weeks (from 69.8 to 62.7; p = 0.048), with return to baseline levels after 3 months (68.5; p = 0.32) and stable at 1 year. Unemployment, low income, and adjuvant therapy correlated with lower Global health status at 3 months.
The significant proportion of patients with anxiety symptoms preoperatively reduced prompt after surgery, while the proportion with depression remained constant, indicating that the primary treatment has no long-term negative effect on patients' mental health. At 3 months, there is no obvious remaining negative impact on patients' HRQoL, and these results are consistent after 1 year.
本研究旨在探讨接受机器人手术治疗子宫内膜癌（EC）的患者在长期内焦虑和抑郁症状以及 HRQoL 方面受到的影响。
本单中心研究纳入了 64 名计划接受原发性机器人手术治疗 EC 的女性患者。在基线时获得了社会经济变量。前瞻性地从基线随访至术后 2 周、3 个月和 1 年，使用欧洲癌症研究和治疗组织生活质量问卷核心 30 项（QLQ-C30）、EC 模块（EN24）、广泛性焦虑障碍量表（GAD-7）和患者健康问卷抑郁量表（PHQ-9）。
基线时有 17 名（27.0%）患者的焦虑评分超过临床阈值，术后 2 周时降至 4 名（7.0%）（p=0.012）。基线时有 20%的患者存在抑郁症状，在一年的随访过程中无明显变化（p=0.58）。在术后 2 周时，整体健康状况评分显著下降（从 69.8 降至 62.7；p=0.048），但在术后 3 个月时恢复至基线水平（68.5；p=0.32），并在 1 年时保持稳定。失业、低收入和辅助治疗与术后 3 个月时较低的整体健康状况相关。
术前存在焦虑症状的患者比例在手术后迅速降低，而存在抑郁症状的患者比例保持不变，这表明主要治疗对患者的心理健康没有长期负面影响。在术后 3 个月时，患者的 HRQoL 没有明显的剩余负面影响，且这些结果在 1 年后仍然一致。
