Network analysis of core symptom changes in Chinese patients undergoing radical prostatectomy for prostate cancer: a longitudinal study.

OBJECTIVE

To construct symptom networks at different time points during the early postoperative period in patients undergoing radical prostatectomy and to identify the core symptom at each stage.

METHODS

This longitudinal study used convenience sampling to recruit patients who underwent radical prostatectomy for prostate cancer in the urology departments of two tertiary grade A hospitals in Chongqing, China, between August 2024 and September 2025. Data were collected at 7 days (T1), 1 month (T2), and 3 months (T3) after surgery using a general information questionnaire and the Chinese version of the Memorial Symptom Assessment Scale. Symptom networks were estimated using R, and strength centrality was used to identify the core symptom at each time point.

RESULTS

Symptom network analysis showed that the T1 network included 12 nodes, with pain having the highest strength centrality (rs = 1.76), identifying it as the core symptom at 7 days after surgery. The T2 network included 10 nodes, with worrying having the highest strength centrality (rs = 1.28), making it the core symptom at 1 month after surgery. The T3 network also included 10 nodes, and worrying remained the most central symptom (rs = 1.32), identifying it as the core symptom at 3 months after surgery.

CONCLUSION

Core symptoms differed across stages of early postoperative recovery in radical prostatectomy patients. Healthcare professionals should develop continuous, anticipatory, and targeted intervention strategies based on the core symptoms identified at each time point, identify symptom risks as early as possible, and implement precision symptom management to improve patients' symptom experience during early postoperative recovery and enhance the efficiency of symptom management.