Tao Fengyan, Gong Lili, Dong Qing
Nangtong Health College of Jiangsu Province, Nantong, China.
Department of Chemotherapy, the Affiliated Hospital of Nantong University, Nantong, China.
J Gastrointest Oncol. 2023 Apr 29;14(2):952-962. doi: 10.21037/jgo-23-248.
Most patients with advanced gastric cancer (GC) are treated with systemic chemotherapy and many factors have remarkable impacts on their prognosis. However, the importance of psychological status in the prognosis of advanced GC patients is still unclear. This prospective study was performed to analyze the impact of negative emotions on GC patients treated with systemic chemotherapy.
Advanced GC patients admitted to our hospital between January 2017 and March 2019 were prospectively enrolled. Demographic and clinical data were collected, as were any adverse events (AEs) related to systemic chemotherapy. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess negative emotions. The primary outcome was progression-free survival (PFS) and overall survival (OS), and the secondary outcome was the quality of life which was assessed by The European Organization for Research and Treatment of Quality of Life Questionnaire-Core 30. Cox proportional hazards models were used to analyze the effects of negative emotions on prognosis, and logistic regression models were used to analyze the risk factors related to negative emotions.
A total of 178 advanced GC patients were enrolled in this study. A total of 83 patients were divided into a negative emotion group and 95 patients were divided into normal emotion group. 72 patients experienced AEs during treatment. Many more patients experienced AEs in the negative emotion group than in the normal emotion group (62.7% vs. 21.1%, P<0.001). Enrolled patients were followed up for at least 3 years. It was found both PFS and OS were much lower in the negative emotion group than in the normal emotion group (P=0.0186 and 0.0387, respectively). Participants in negative emotion group had lower health status and more severe symptoms. Negative emotions, lower body mass index (BMI), and IV tumor stage were identified as risk factors. In addition, higher BMI and marital status were identified as protective factors of negative emotions.
Negative emotions have a significant adverse effect on the prognosis of GC patients. The main risk factor of negative emotions is AEs during treatment. It is necessary to closely monitor the treatment process and improve the psychological status of patients.
大多数晚期胃癌（GC）患者接受全身化疗，许多因素对其预后有显著影响。然而，心理状态在晚期GC患者预后中的重要性仍不清楚。本前瞻性研究旨在分析负面情绪对接受全身化疗的GC患者的影响。
前瞻性纳入2017年1月至2019年3月期间我院收治的晚期GC患者。收集人口统计学和临床数据，以及与全身化疗相关的任何不良事件（AE）。采用自评焦虑量表（SAS）和自评抑郁量表（SDS）评估负面情绪。主要结局是无进展生存期（PFS）和总生存期（OS），次要结局是生活质量，通过欧洲癌症研究与治疗组织生活质量问卷核心30进行评估。采用Cox比例风险模型分析负面情绪对预后的影响，采用逻辑回归模型分析与负面情绪相关的危险因素。
本研究共纳入178例晚期GC患者。83例患者分为负面情绪组，95例患者分为正常情绪组。72例患者在治疗期间出现AE。负面情绪组出现AE的患者比正常情绪组多得多（62.7%对21.1%，P<0.001）。纳入的患者至少随访3年。发现负面情绪组的PFS和OS均远低于正常情绪组（分别为P=0.0186和0.0387）。负面情绪组的参与者健康状况较差，症状更严重。负面情绪、较低的体重指数（BMI）和IV期肿瘤分期被确定为危险因素。此外，较高的BMI和婚姻状况被确定为负面情绪的保护因素。
负面情绪对GC患者的预后有显著不良影响。负面情绪的主要危险因素是治疗期间的AE。有必要密切监测治疗过程并改善患者的心理状态。
