The Association Between Postoperative Recovery and Psychosocial Factors in Cancer Patients
Journal of Surgery
Volume 8, Issue 1, February 2020, Pages: 9-15
Received: Jan. 5, 2020;
Accepted: Jan. 20, 2020;
Published: Feb. 4, 2020
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Saho Wada, Department of Psycho-Oncology, National Cancer Center Hospital. Tokyo, Japan; Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
Ryoichi Sadahiro, Department of Psycho-Oncology, National Cancer Center Hospital. Tokyo, Japan; Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
Yutaka Matsuoka, Department of Psycho-Oncology, National Cancer Center Hospital. Tokyo, Japan; Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan; Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
Yosuke Uchitomi, Department of Psycho-Oncology, National Cancer Center Hospital. Tokyo, Japan; Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan; Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
Ken Shimizu, Department of Psycho-Oncology, National Cancer Center Hospital. Tokyo, Japan; Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan; Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
Surgery is one of the main treatments component against cancer. Although the basic principle of surgical treatment of cancer is curability, safety, and functionality, early recovery after surgery is also important. While some previous studies focus on physical recovery, there are few studies regarding the perioperative period of cancer patients and their impact on postoperative recovery. This study is aim to clarify psychosocial factors that affect postoperative recovery in cancer patients. The study design is a secondary data analysis of a prospective observational cohort study whose primary purpose was to investigate whether preoperative anxiety predicted onset of postoperative delirium in cancer patients at the National Cancer Center Hospital in Japan. The primary outcome of this study was the length of postoperative hospital stay, and the secondary outcome was postoperative complications. We conducted multivariable regression analysis to determine psychosocial predictors of primary and secondary outcomes. The final analysis included 109 patients. The mean length of postoperative hospital stay was 23.4 (SD = 12.4) days and the incidence rate of postoperative complications was 32.1%. In multivariable regression, preoperative anxiety was positively associated with the length of postoperative hospital stay, while sex (female) and alcohol dependence showed a negative association. Cognitive function was marginally associated with postoperative complications. In conclusion, Appropriate management of preoperative anxiety contributes to early discharge after surgery in cancer patients.
The Association Between Postoperative Recovery and Psychosocial Factors in Cancer Patients, Journal of Surgery.
Vol. 8, No. 1,
2020, pp. 9-15.
Yamaguchi K. Gan to Mukiatta 4,054nin no Koe. (in Japanese). Survey on worries and burdens of cancer survivors. 2016.
Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS ((R))) society recommendations. Clin Nutr. 2013 Dec; 32 (6): 879-87.
Connor S, Cross A, Sakowska M, Linscott D, Woods J. Effects of introducing an enhanced recovery after surgery programme for patients undergoing open hepatic resection. HPB (Oxford). 2013 Apr; 15 (4): 294-301.
Dunne DF, Yip VS, Jones RP, McChesney EA, Lythgoe DT, Psarelli EE, et al. Enhanced recovery in the resection of colorectal liver metastases. J Surg Oncol. 2014 Aug; 110 (2): 197-202.
Stowers MD, Lemanu DP, Hill AG. Health economics in Enhanced Recovery After Surgery programs. Can J Anaesth. 2015 Feb; 62 (2): 219-30.
Dort JC, Farwell DG, Findlay M, Huber GF, Kerr P, Shea-Budgell MA, et al. Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society. JAMA Otolaryngol Head Neck Surg. 2017 Mar 1; 143 (3): 292-303.
Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017 Mar 1; 152 (3): 292-98.
Koizumi A, Matsushima E, Mochizuki Y, Omura K, Amagasa T. Changes in the psychological characteristics of oral cancer patients in the perioperative period: a quantitative evaluation. J Med Dent Sci. 2013 Mar 1; 60 (1): 41-53.
Aigner CJ, Hernandez M, Koyyalagunta L, Novy D. The association of presurgery psychological symptoms with postsurgery pain among cancer patients receiving implantable devices for pain management. Support Care Cancer. 2014 Sep; 22 (9): 2323-8.
Schreiber KL, Kehlet H, Belfer I, Edwards RR. Predicting, preventing and managing persistent pain after breast cancer surgery: the importance of psychosocial factors. Pain Manag. 2014; 4 (6): 445-59.
Spiegel D, Giese-Davis J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry. 2003 Aug 1; 54 (3): 269-82.
Horowitz M, Neeman E, Sharon E, Ben-Eliyahu S. Exploiting the critical perioperative period to improve long-term cancer outcomes. Nat Rev Clin Oncol. 2015 Apr; 12 (4): 213-26.
Bouchard LC, Antoni MH, Blomberg BB, Stagl JM, Gudenkauf LM, Jutagir DR, et al. Postsurgical Depressive Symptoms and Proinflammatory Cytokine Elevations in Women Undergoing Primary Treatment for Breast Cancer. Psychosom Med. 2016 Jan; 78 (1): 26-37.
Ghoneim MM, O'Hara MW. Depression and postoperative complications: an overview. BMC Surg. 2016 Feb 02; 16: 5.
Hodes GE, Menard C, Russo SJ. Integrating Interleukin-6 into depression diagnosis and treatment. Neurobiol Stress. 2016 Oct; 4: 15-22.
Andersen BL, Goyal NG, Westbrook TD, Bishop B, Carson WE, 3rd. Trajectories of Stress, Depressive Symptoms, and Immunity in Cancer Survivors: Diagnosis to 5 Years. Clin Cancer Res. 2017 Jan 01; 23 (1): 52-61.
Wada S, Inoguchi H, Sadahiro R, Matsuoka YJ, Uchitomi Y, Sato T, et al. Preoperative Anxiety as a Predictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study. World J Surg. 2018 Aug 20.
Leung JM, Sands LP, Mullen EA, Wang Y, Vaurio L. Are preoperative depressive symptoms associated with postoperative delirium in geriatric surgical patients? J Gerontol A Biol Sci Med Sci. 2005 Dec; 60 (12): 1563-8.
Kalisvaart KJ, Vreeswijk R, de Jonghe JF, van der Ploeg T, van Gool WA, Eikelenboom P. Risk factors and prediction of postoperative delirium in elderly hip-surgery patients: implementation and validation of a medical risk factor model. J Am Geriatr Soc. United States: 2006. Vol. 5, p. 817-22.
Smith PJ, Attix DK, Weldon BC, Greene NH, Monk TG. Executive function and depression as independent risk factors for postoperative delirium. Anesthesiology. 2009 Apr; 110 (4): 781-7.
Serafim RB, Dutra MF, Saddy F, Tura B, de Castro JE, Villarinho LC, et al. Delirium in postoperative nonventilated intensive care patients: risk factors and outcomes. Ann Intensive Care. 2012; 2 (1): 51.
Shah S, Weed HG, He X, Agrawal A, Ozer E, Schuller DE. Alcohol-related predictors of delirium after major head and neck cancer surgery. Arch Otolaryngol Head Neck Surg. 2012 Mar; 138 (3): 266-71.
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J (Clin Res Ed). 1986 Feb 1; 292 (6516): 344.
Kugaya A, Akechi T, Okuyama T, Okamura H, Uchitomi Y. Screening for psychological distress in Japanese cancer patients. Jpn J Clin Oncol. 1998 May; 28 (5): 333-8.
Takahashi S, Oono y. Desk reference to the diagnostic criteria from DSM-5. 2014.
Litaker D, Locala J, Franco K, Bronson DL, Tannous Z. Preoperative risk factors for postoperative delirium. Gen Hosp Psychiatry. 2001 Mar-Apr; 23 (2): 84-9.
Barber EL, Van Le L. Enhanced Recovery Pathways in Gynecology and Gynecologic Oncology. Obstet Gynecol Surv. 2015 Dec; 70 (12): 780-92.
Gemmill EH, Humes DJ, Catton JA. Systematic review of enhanced recovery after gastro-oesophageal cancer surgery. Ann R Coll Surg Engl. 2015 Apr; 97 (3): 173-9.
Li M, Zhang W, Jiang L, Yang J, Yan L. Fast track for open hepatectomy: A systemic review and meta-analysis. Int J Surg. 2016 Dec; 36 (Pt A): 81-89.
Wang L, Zhu C, Ma X, Shen K, Li H, Hu Y, et al. Impact of enhanced recovery program on patients with esophageal cancer in comparison with traditional care. Support Care Cancer. 2017 Feb; 25 (2): 381-89.
Yoshimura Y, Kubo S, Shirata K, Hirohashi K, Tanaka H, Shuto T, et al. Risk factors for postoperative delirium after liver resection for hepatocellular carcinoma. World J Surg. 2004 Oct; 28 (10): 982-6.
Takeuchi M, Takeuchi H, Fujisawa D, Miyajima K, Yoshimura K, Hashiguchi S, et al. Incidence and risk factors of postoperative delirium in patients with esophageal cancer. Ann Surg Oncol. 2012 Nov; 19 (12): 3963-70.
Hempenius L, Slaets JP, van Asselt DZ, Schukking J, de Bock GH, Wiggers T, et al. Interventions to prevent postoperative delirium in elderly cancer patients should be targeted at those undergoing nonsuperficial surgery with special attention to the cognitive impaired patients. Eur J Surg Oncol. 2015 Jan; 41 (1): 28-33.
El Jawahri A, Traeger L, Park E, Greer J, Pirl W, Lennes I, et al. Associations among prognostic understanding, quality of life, and mood in patients with advanced cancer.
Oliveira Miranda D, Soares de Lima TA, Ribeiro Azevedo L, Feres O, Ribeiro da Rocha JJ, Pereira-da-Silva G. Proinflammatory cytokines correlate with depression and anxiety in colorectal cancer patients. Biomed Res Int. 2014.
Furtado M, Katzman MA. Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders. Psychiatry Res. 2015 Sep 30; 229 (1-2): 37-48.
Murphy TM, O'Donovan A, Mullins N, O'Farrelly C, McCann A, Malone K. Anxiety is associated with higher levels of global DNA methylation and altered expression of epigenetic and interleukin-6 genes. Psychiatr Genet. 2015 Apr; 25 (2): 71-8.
Steinweg DL, Worth H. Alcoholism: the keys to the CAGE. Am J Med. 1993 May; 94 (5): 520-23.
Frank D, DeBenedetti AF, Volk RJ, Williams EC, Kivlahan DR, Bradley KA. Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. J Gen Intern Med. 2008 Jun; 23 (6): 781-7.
Freeman WM, Vrana KE. Future prospects for biomarkers of alcohol consumption and alcohol-induced disorders. Alcohol Clin Exp Res. 2010 Jun; 34 (6): 946-54.
Bowyer A, Royse CF. The future of postoperative quality of recovery assessment: multidimensional, dichotomous, and directed to individualize care to patients after surgery. Curr Opin Anaesthesiol. 2016 Dec; 29 (6): 683-90.
Bowyer AJ, Royse CF. Postoperative recovery and outcomes--what are we measuring and for whom? Anaesthesia. 2016 Jan; 71 Suppl 1: 72-7.