Annali italiani di chirurgia · 2025
Effects of Neoadjuvant Chemotherapy on Early Postoperative Anxiety and Depression in Patients With Gastric Cancer: An Observational Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Cao Dong, Yu Ruiqian, Liu Hongming, Li Fuping, Xie Weixun, Tuo Chuanlei, He Jun, Hu Chengyu, Luo Bixian, Liu Yong, Gong Weihua
Аннотация
AIM: Neoadjuvant chemotherapy (NACT) improves surgical outcomes in gastric cancer, yet its effect on early postoperative mental health remains unclear. This study aims to investigate the association between NACT and postoperative anxiety and depression.
METHODS: A single-center, retrospective cohort study included 201 gastric cancer patients who underwent surgical resection from October 2023 to May 2024, categorized by NACT receipt. Psychological evaluation in the early postoperative phase was conducted using the Hospital Anxiety and Depression Scale (HADS), and associations with NACT were assessed through logistic regression.
RESULTS: Of the 201 patients, 57 (28.4%) received NACT. Postoperative assessments showed significantly higher rates of anxiety (78.95% vs. 61.11%, p = 0.016) and depression (56.14% vs. 38.89%, p = 0.026) in NACT recipients compared to non-NACT patients. After adjusting for confounders, NACT remained independently associated with an increased prevalence of anxiety (Odds Ratio [OR] = 2.25) and depression (OR = 2.00, both p < 0.05). Patients undergoing more than three NACT cycles exhibited increased anxiety (91.67% vs. 69.70%, p = 0.045) and depression (75.00% vs. 42.42%, p = 0.014), with higher mean HADS scores (both p < 0.05). These associations persisted in adjusted analyses for depression (OR, 4.07; 95% Confidence Interval [CI], 1.28-12.90; p = 0.017) and were marginal for anxiety (OR, 4.78; 95% CI, 0.94-24.33; p = 0.059). Patients with poor response (tumor regression grade [TRG] 2-3) also showed a trend toward increased anxiety risk (OR, 3.30; 95% CI, 0.83-13.12; p = 0.089).
CONCLUSIONS: NACT is independently associated with increased anxiety and depression in the early postoperative period, especially if chemotherapy cycles are prolonged.
METHODS: A single-center, retrospective cohort study included 201 gastric cancer patients who underwent surgical resection from October 2023 to May 2024, categorized by NACT receipt. Psychological evaluation in the early postoperative phase was conducted using the Hospital Anxiety and Depression Scale (HADS), and associations with NACT were assessed through logistic regression.
RESULTS: Of the 201 patients, 57 (28.4%) received NACT. Postoperative assessments showed significantly higher rates of anxiety (78.95% vs. 61.11%, p = 0.016) and depression (56.14% vs. 38.89%, p = 0.026) in NACT recipients compared to non-NACT patients. After adjusting for confounders, NACT remained independently associated with an increased prevalence of anxiety (Odds Ratio [OR] = 2.25) and depression (OR = 2.00, both p < 0.05). Patients undergoing more than three NACT cycles exhibited increased anxiety (91.67% vs. 69.70%, p = 0.045) and depression (75.00% vs. 42.42%, p = 0.014), with higher mean HADS scores (both p < 0.05). These associations persisted in adjusted analyses for depression (OR, 4.07; 95% Confidence Interval [CI], 1.28-12.90; p = 0.017) and were marginal for anxiety (OR, 4.78; 95% CI, 0.94-24.33; p = 0.059). Patients with poor response (tumor regression grade [TRG] 2-3) also showed a trend toward increased anxiety risk (OR, 3.30; 95% CI, 0.83-13.12; p = 0.089).
CONCLUSIONS: NACT is independently associated with increased anxiety and depression in the early postoperative period, especially if chemotherapy cycles are prolonged.