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小肾肿块患者癌症复发恐惧的对比分析:主动监测与冷冻消融。

A comparative analysis of fear of cancer recurrence in patients with small renal masses: Active surveillance versus cryoablation.

机构信息

Department of Urology, Aarhus University Hospital, Aarhus, Denmark.

Research and Innovation Unit of Radiology - UNIFY, SDU, Odense, Denmark; Radiological Research and Innovation Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Urology, Odense University Hospital, Odense, Denmark.

出版信息

Acta Oncol. 2024 Jul 22;63:573-579. doi: 10.2340/1651-226X.2024.40418.

Abstract

BACKGROUND AND PURPOSE

The aim of this study was to evaluate and compare the fear of cancer recurrence (FCR) in patients diagnosed with a small renal mass (SRM) and managed with either active surveillance (AS) or minimal invasive renal cryoablation (CA).

PATIENTS/MATERIAL AND METHODS: A total of 398 patients with SRMs (263 AS and 135 CA patients) were retrospectively identified across three institutions and invited to complete the Fear of Cancer Recurrence-Short Form (FCRI-SF) questionnaire.

RESULTS

No statistically significant differences in FCRI-SF score were observed between the AS (mean = 10.9, standard deviation [SD] = 6.9) and CA (mean = 10.2, SD = 7.2) (p = 0.559) patients, with the mean scores of both groups being below the suggested clinically significant cut-off of 16. A total of 25% of AS and 28% of CA patients reported sub-clinical or clinical levels of FCR (FCRI-SF score > 16). Within the AS group, a weak negative association between FCR severity and age was observed (r = -0.23, p = 0.006), and a statistically significant difference in FCRI-SF score between patients aged more or less than 73 years (p = 0.009).

INTERPRETATION

FCR levels were comparable between AS and CA patients, suggesting that treatment decisions should prioritise clinical factors. Up to 28% of AS and CA patients report clinically significant FCR, highlighting the importance of considering the possibility of FCR, especially in younger patients.

摘要

背景与目的

本研究旨在评估和比较经小肾肿块(SRM)诊断并接受主动监测(AS)或微创肾冷冻消融(CA)治疗的患者的癌症复发恐惧(FCR)。

患者/材料与方法:共在三家机构回顾性地确定了 398 名患有 SRM 的患者(263 名 AS 和 135 名 CA 患者),并邀请他们完成恐惧癌症复发-短式量表(FCRI-SF)问卷。

结果

AS 组(平均为 10.9,标准差[SD]为 6.9)和 CA 组(平均为 10.2,SD 为 7.2)的 FCRI-SF 评分之间没有统计学上的显著差异(p = 0.559),两组的平均得分均低于建议的 16 分的临床显著截断值。25%的 AS 和 28%的 CA 患者报告存在亚临床或临床水平的 FCR(FCRI-SF 评分>16)。在 AS 组中,FCR 严重程度与年龄之间存在微弱的负相关(r = -0.23,p = 0.006),并且 73 岁以上和以下的患者之间的 FCRI-SF 评分存在统计学差异(p = 0.009)。

结论

AS 和 CA 患者的 FCR 水平相当,这表明治疗决策应优先考虑临床因素。高达 28%的 AS 和 CA 患者报告存在临床显著的 FCR,这突出了考虑 FCR 可能性的重要性,尤其是在年轻患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c43a/11332454/8698e27edb1f/AO-63-40418-g001.jpg

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