Deng Huili, Yang Tiantian, Hu Yuru, Liu Junjie, Chou HsiuLing, Jiang Yang, Shen Qu
School of Medicine, Xiamen University, Xiamen City, China.
College of Science and Technology, China Three Gorges University, Yichang City, China.
Support Care Cancer. 2025 Feb 25;33(3):219. doi: 10.1007/s00520-025-09180-8.
Gastric cancer is a common tumor globally. Surgery is the preferred treatment for gastric cancer. Yet, little is known about its symptom clusters, fear of disease progression, and quality of life (QoL). This study aims to investigate the severity of symptom clusters, fear of disease progression, and quality of life of postoperative gastric cancer patients; to analyze the correlation between symptom clusters, fear of disease progression, and quality of life of postoperative gastric cancer patients; and to provide theoretical bases for the development of an intervention plan to enhance the quality of life of postoperative gastric cancer patients.
A convenience sampling method was used to select 158 postoperative gastric cancer patients from a tertiary hospital in Xiamen City from January 2023 to April 2023 for the study. Data were collected using the General Information Evaluation Form, M.D. Anderson Symptom Inventory-Gastrointestinal Cancer Module (MDASI-GI), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed with EpiData 3.1 and SPSS 26.0. Symptom clusters were extracted via exploratory factor analysis. Differences in QoL based on patient characteristics were analyzed using t tests or one-way analysis of variance (ANOVA). Pearson correlation and multiple linear regression analyses were used to explore relationships among symptom clusters, fear of disease progression, and QoL.
The overall quality of life score in the FACT-G scale was (52.32 ± 10.58), of which the social/family status score was (16.47 ± 3.62), the physical status score was (14.24 ± 5.66), the functional status was (11.35 ± 4.48), and the emotional status score was (10.25 ± 3.53). The fear of disease progression score of postoperative gastric cancer patients was (37.37 ± 6.37), of which the physical health dimension score was (21.58 ± 4.01), and the social/family dimension score was (15.74 ± 4.07). Two symptom clusters were identified: physical/emotional sickness and gastrointestinal symptom cluster. The results of Pearson correlation analysis showed that symptom cluster severity was negatively correlated with quality of life (r = - 0.508, P < 0.01); symptom cluster severity was significantly positively correlated with fear of disease progression (r = 0.260, P < 0.01); and fear of disease progression was significantly negatively correlated with quality of life (r = - 0.194, P < 0.05). Multiple linear regression analyses showed that the physical/emotional sickness symptom cluster, physical health fears, and physical state of postoperative gastric cancer patients were the affecting factors of quality of life (P < 0.001).
Two symptom clusters were identified in postoperative gastric cancer patients in mainland China. Fear of disease progression was at a medium-high level, and QoL was at a medium level. Common symptoms included fatigue, pain, and worry. The physical state, physical health, and the physical/emotional sickness symptom cluster affect the quality of life of postoperative gastric cancer patients. Targeted clinical interventions are necessary to improve QoL in postoperative gastric cancer patients.
胃癌是全球常见的肿瘤。手术是胃癌的首选治疗方法。然而，对于其症状群、疾病进展恐惧及生活质量（QoL）了解甚少。本研究旨在调查胃癌术后患者症状群的严重程度、疾病进展恐惧及生活质量；分析胃癌术后患者症状群、疾病进展恐惧与生活质量之间的相关性；为制定提高胃癌术后患者生活质量的干预计划提供理论依据。
采用便利抽样法，选取2023年1月至2023年4月厦门市某三级医院的158例胃癌术后患者进行研究。使用一般信息评估表、MD安德森症状问卷-胃肠癌模块（MDASI-GI）、疾病进展恐惧问卷简表（FoP-Q-SF）和癌症治疗功能评估-通用版（FACT-G）收集数据。数据用EpiData 3.1和SPSS 26.0进行分析。通过探索性因素分析提取症状群。采用t检验或单因素方差分析（ANOVA）分析基于患者特征的生活质量差异。采用Pearson相关性分析和多元线性回归分析探讨症状群、疾病进展恐惧与生活质量之间的关系。
FACT-G量表中生活质量总分为（52.32±10.58），其中社会/家庭状况分为（16.47±3.62），身体状况分为（14.24±5.66），功能状况分为（11.35±4.48），情感状况分为（10.25±3.53）。胃癌术后患者疾病进展恐惧评分为（37.37±6.37），其中身体健康维度分为（21.58±4.01），社会/家庭维度分为（15.74±4.07）。识别出两个症状群：身体/情绪不适和胃肠道症状群。Pearson相关性分析结果显示，症状群严重程度与生活质量呈负相关（r = -0.508，P < 0.01）；症状群严重程度与疾病进展恐惧呈显著正相关（r = 0.260，P < 0.01）；疾病进展恐惧与生活质量呈显著负相关（r = -0.194，P < 0.05）。多元线性回归分析显示，身体/情绪不适症状群、身体健康恐惧及胃癌术后患者的身体状况是生活质量的影响因素（P < 0.001）。
在中国大陆的胃癌术后患者中识别出两个症状群。疾病进展恐惧处于中高水平，生活质量处于中等水平。常见症状包括疲劳、疼痛和担忧。身体状况、身体健康及身体/情绪不适症状群影响胃癌术后患者的生活质量。有必要进行针对性的临床干预以提高胃癌术后患者的生活质量。
