Psychological distress associated with active surveillance in patients younger than 70 with a small renal mass.
Urol Oncol
; 38(6): 603.e17-603.e25, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32253117
ABSTRACT
PURPOSE:
To compare the psychological distress throughout several predefined disease time points in patients younger than 70 with small renal masses (SRMs) treated with either active surveillance (AS) or ablative/surgical therapy.METHODS:
Using the Edmonton Symptom Assessment System - revised (ESAS-r) questionnaire, we focused on psychological distress symptoms in all consecutive patients with an SRM between 2014 and 2017. We further evaluated the psychological distress sub-score (PDSS) of ESAS-r, consisting of the sum scores of anxiety, depression, and well-being. PDSS of patients treated with AS or ablation/surgery were compared at 4 distinct time points (before and after diagnosis, after a biopsy is performed, and at last follow-up). Multivariable linear regression models were performed to assess factors associated with worse PDSS (1-point score increase).RESULTS:
We examined 477 patients, of whom 217 and 260 were treated with AS and surgery/ablation, respectively. Similar ESAS-r and PDSS scores were shown at all predefined disease time points except following an SRM biopsy and at last, follow-up, where AS-treated patients with a biopsy-proven malignancy had significantly worse PDSS (11.4 vs. 6.1, Pâ¯=â¯0.035), and (13.2 vs. 5.4, Pâ¯=â¯0.004), respectively. At last follow-up, multivariable linear models demonstrated that a biopsy-proven malignancy (Bâ¯=â¯2.630, 95% CI 0.024-5.236, Pâ¯=â¯0.048) and AS strategy (Bâ¯=â¯6.499, 95% CI 2.340-10.658, Pâ¯=â¯0.002) were associated with worse PDSS in all patients, and in those who underwent a biopsy, respectively.CONCLUSIONS:
Offering standardized psychological supportive care may be required for patients younger than 70 years on AS for SRM, especially for those with a biopsy-proven tumor.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Espera Vigilante
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Distrés Psicológico
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Neoplasias Renales
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2020
Tipo del documento:
Article