Does active surveillance for men with localized prostate cancer carry psychological morbidity?
Does active surveillance for men with localized prostate cancer carry psychological morbidity?
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DOI：
10.1111/j.1464-410x.2007.07009.x
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发表时间：
2007-09-01
影响因子：
4.5
通讯作者：
Watson, Maggie
中科院分区：
文献类型：
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作者：
Burnet, Katriina L.;Parker, Chris;Watson, Maggie
在一项横断面研究中，与接受立即治疗的患者相比，通过主动监测管理的局限性前列腺癌患者的焦虑和抑郁患病率，因为主动监测是管理这种疾病的一种相对较新的方法，旨在避免“不必要的”治疗，但尚不清楚这种方法是否会导致心理困扰，研究人员在门诊部连续接触了764名前列腺癌患者。其中，329名患有局部疾病的男性（cT1/2，N0/NX，M0/MX）符合研究入选标准，完成医院焦虑抑郁量表（HADS）; 100人接受积极监测，81人目前正在接受根治性治疗（放疗+新辅助激素治疗）和148人以前接受过根治性放疗。总的来说，16%（51/329）的患者符合HADS焦虑标准，6%（20/329）的患者符合抑郁标准。分析表明，较高的焦虑评分与年龄较小（P <0.01）和自诊断以来的间隔时间较长（P <0.01）显著相关，但与主动监测的管理无关（P = 0.38）。较高的抑郁评分与诊断后较长的间隔时间显著相关（P <0.05），但与积极监测的管理无关（P = 0.83）。与前列腺癌的更及时治疗相比，积极监测管理局限性前列腺癌与更大的心理困扰无关。
To investigate, in a cross-sectional study, the prevalence of anxiety and depression in patients with localised prostate cancer managed by active surveillance, compared with those receiving immediate treatment, as active surveillance is a relatively new approach to managing this disease, designed to avoid 'unnecessary' treatment, but it is unclear whether the approach contributes to psychological distress, given that men are living with untreated cancer.A consecutive series of 764 patients with prostate cancer were approached in outpatient clinics. Of these, 329 men with localized disease (cT1/2, N0/NX, M0/MX) meeting the study entry criteria, completed the Hospital Anxiety and Depression Scale (HADS); 100 were on active surveillance, 81 were currently receiving radical treatment (radiotherapy + neoadjuvant hormone therapy) and 148 had previously received radical radiotherapy.Overall, 16% (51/329) of patients met the HADS criteria for anxiety and 6% (20/329) for depression. Analyses indicated that higher anxiety scores were significantly associated with younger age (P < 0.01) and a longer interval since diagnosis (P < 0.01), but not with management by active surveillance (P = 0.38). Higher depression scores were significantly associated with a longer interval since diagnosis (P < 0.05), but not with management by active surveillance (P = 0.83).Active surveillance for managing localized prostate cancer was not associated with greater psychological distress than more immediate treatment for prostate cancer.