医学
苦恼
危险系数
内科学
队列研究
队列
癌症
结直肠癌
回顾性队列研究
疾病
置信区间
临床心理学
作者
Jung Kyong Shin,Danbee Kang,Soohyun Kim,Youngeun Choi,Woo Yong Lee,Seong Hyeon Yun,Yong Beom Cho,Jung Wook Huh,Yoon Ah Park,Juhee Cho,Hee Cheol Kim
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2023-01-03
卷期号:278 (3): e534-e539
标识
DOI:10.1097/sla.0000000000005791
摘要
This study aimed to evaluate the association between distress at initial diagnosis and disease-free survival in patients with resectable colon cancer.Considerable research has examined the psychological impact of having a confirmed diagnosis of cancer, but relatively limited research has examined the impact of distress during the diagnostic phase on oncological outcomes.This is a retrospective cohort study. We included newly diagnosed colon cancer patients who had resectable surgery and underwent distress screening between July 2014 and July 2021 (N=1,362). The Korean versions of the Distress Thermometer were used to assess distress and related problems. Patients were categorized into 3 groups based on distress score: low (<4), moderate (4-7), and severe (≥8). The primary outcome was disease-free survival.The mean distress was 5.1 (SD=2.4) and 61%, and 15% of patients had moderate and severe distress at diagnosis, respectively. The severe distress group was more likely to report fear, sadness, and concerns regarding insurance/finance, work, and childcare than the low distress group. Compared with the low distress group, the severe distress group had worse disease-free survival (Hazard Ratio=1.84, 95% CI=1.03, 3.29). The association was more evident in patients with stage IV disease (Hazard Ratio=2.53, 95% CI=1.02, 6.25).A substantial number of patients with colon cancer experience distress at diagnosis, and severe distress has a negative impact on oncologic outcomes. Active monitoring and appropriate management of distress at diagnosis should be adopted at clinical settings.
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