The psychological impact of symptoms related to esophagogastric cancer resection presenting in primary care: A national linked database study

Title: The psychological impact of symptoms related to esophagogastric cancer resection presenting in primary care: A national linked database study
Authors: Bouras, G
Markar, SR
Burns, EM
Huddy, JR
Bottle, A
Athanasiou, T
Darzi, A
Hanna, GB
Item Type: Journal Article
Abstract: Background The objective was to evaluate incidence, risk factors and impact of postoperative symptoms following esophagogastric cancer resection in primary care. Methods Patients undergoing esophagogastrectomy for cancer from 1998 to 2010 with linked records in Clinical Practice Research Datalink, Hospital Episodes Statistics and Office of National Statistics databases were studied. The recording of codes for reflux, dysphagia, dyspepsia, nausea, vomiting, dumping, diarrhea, steatorrhea, appetite loss, weight loss, pain and fatigue were identified up to 12 months postoperatively. Psychiatric morbidity was also examined and its risk evaluated by logistic regression analysis. Results Overall, 58.6% (1029/1755) of patients were alive 2 years after surgery. Of these, 41.1% had recorded postoperative symptoms. Reflux, dysphagia, dyspepsia and pain were more frequent following esophagectomy compared with gastrectomy (p < 0.05). Complications (OR = 1.40 95%CI 1.00–1.95) and surgical procedure predicted postoperative symptoms (p < 0.05). When compared with partial gastrectomy, esophagectomy (OR = 2.03 95%CI 1.26–3.27), total gastrectomy (OR = 2.44 95%CI 1.57–3.79) and esophagogastrectomy (OR = 2.66 95%CI 1.85–2.86) were associated with postoperative symptoms (p < 0.05). The majority of patients with postoperative psychiatric morbidity had depression or anxiety (98%). Predictors of postoperative depression/anxiety included younger age (OR = 0.97 95%CI 0.96–0.99), complications (OR = 2.40 95%CI 1.51–3.83), psychiatric history (OR = 6.73 95%CI 4.25–10.64) and postoperative symptoms (OR = 1.78 95%CI 1.17–2.71). Conclusions Over 40% of patients had symptoms related to esophagogastric cancer resection recorded in primary care, and were associated with an increase in postoperative depression and anxiety.
Issue Date: 9-Nov-2016
Date of Acceptance: 13-Oct-2016
URI: http://hdl.handle.net/10044/1/45342
DOI: https://dx.doi.org/10.1016/j.ejso.2016.10.010
ISSN: 1532-2157
Publisher: Elsevier
Start Page: 454
End Page: 460
Journal / Book Title: European Journal of Surgical Oncology
Volume: 43
Issue: 2
Copyright Statement: © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: RDOTH 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Surgery
Esophageal cancer
Gastric cancer
Postoperative symptoms
Primary care
QUALITY-OF-LIFE
ESOPHAGECTOMY
REFLUX
ESOPHAGITIS
VALIDATION
SURGERY
ENGLAND
TIME
Aged
Anxiety
Depression
England
Esophageal Neoplasms
Esophagectomy
Esophagogastric Junction
Female
Gastrectomy
Humans
Incidence
Male
Medical Record Linkage
Middle Aged
Postoperative Complications
Primary Health Care
Quality of Life
Risk Factors
Stomach Neoplasms
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine
Epidemiology, Public Health and Primary Care



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