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Relationship between psychological distress and health-related quality of life at each point of the treatment of esophageal cancer

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Abstract

Background

Patients with esophageal cancer often feel depression or fear of death influenced by multiple clinical factors. This study sought to investigate the clinical factors associated with psychological distress, focusing on the influence of health-related quality of life (HRQOL) for better psychological management of patients with esophageal cancer.

Methods

In total, 102 of 152 consecutive patients surgically treated at Toranomon Hospital met the eligibility criteria for analysis. Questionnaires designed to identify psychological distress and QOL (EORTC QLQ C-30/OES18) were administered at five time points during the treatment course. Degree of psychological distress was assessed by Hospital Anxiety and Depression Scale (HADS).

Results

Patients with HADS score ≥ 11 at each visit showed significantly higher level of symptoms or problems measured by the score of EORTC QLQ C-30/OES18 compared with those with HADS score ≤ 10. Emotional status was a significant factor associated with psychological distress at all times. Although functional scales including global health status or QOL status and symptom scales associated with esophageal cancer were strongly associated with psychological distress before treatment, scales associated with changes in habitus after esophagectomy showed significant correlation with psychological distress after surgery. No significant correlation was observed between psychological distress and individual baseline characteristics, apart from history of surgery and pathological staging.

Conclusions

Psychological distress during treatment course of esophageal cancer is significantly associated with HRQOL influenced by esophagectomy. The current results may warrant prospective intervention through enhanced recovery after surgery to better manage patients undergoing highly invasive procedures for esophageal cancer.

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Abbreviations

HRQOL:

Health-related quality of life

HADS:

Hospital Anxiety and Depression Scale

EORTC QLQ-C30:

The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30

EORTC QLQ OES-18:

The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire OES 18

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Funding

None declared.

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Authors and Affiliations

  1. Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    Yu Ohkura, Kanako Ichikura & Eisuke Matsushima

  2. Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Yu Ohkura, Junichi Shindoh & Masaki Ueno

  3. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Yu Ohkura, Junichi Shindoh, Masaki Ueno & Harushi Udagawa

  4. Department of Health Science, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan

    Kanako Ichikura

  5. Department of Gastroenterological Surgery, Digestive Tract Center, Toranomon Hospital Kajigaya, Kanagawa, Japan

    Harushi Udagawa

Authors
  1. Yu Ohkura
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  2. Kanako Ichikura
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  3. Junichi Shindoh
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  4. Masaki Ueno
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  5. Harushi Udagawa
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  6. Eisuke Matsushima
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Contributions

YO, KI, and EM designed the study, wrote the manuscript, revised it critically for important intellectual content, and approved its content; YO, KI, JS, MU, HU and EM created the study materials and recruited patients.

Corresponding author

Correspondence to Yu Ohkura.

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Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no competing interests.

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Informed consent was obtained from all individual participants included in the study.

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Ohkura, Y., Ichikura, K., Shindoh, J. et al. Relationship between psychological distress and health-related quality of life at each point of the treatment of esophageal cancer. Esophagus 17, 312–322 (2020). https://doi.org/10.1007/s10388-019-00710-y

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  • DOI: https://doi.org/10.1007/s10388-019-00710-y

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