Postoperative anxiety and depression in surgical gastric cancer patients: their longitudinal change, risk factors, and correlation with survival

Anxiety and depression are important concerns negatively affecting life quality and prognosis in cancer patients. Then, this prospective cohort study aimed to explore the longitudinal change and potential risk factors for postoperative anxiety and depression in surgical gastric cancer patients. A total of 226 surgical gastric cancer patients were consecutively enrolled. The Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression status at baseline (M0), 12(th) month (M12), 24(th) month (M24), and 36(th) month (M36) after hospital discharge, then the HADS for anxiety (HADS-A) score and HADS for depression (HADS-D) score were calculated. Diseasefree survival (DFS) and overall survival (OS) were evaluated. HADS-A and HADS-D scores were gradually increased from M0 to M36, and their occurrences and grades were also worsened piece by piece. Additionally, older age, female, unemployed before surgery, single/divorced/widowed marry status, poor education duration, diabetes, hyperlipidemia, large tumor size, high TNM stage, and adjuvant chemotherapy were independent risk factors for postoperative anxiety or depression. Regarding survival, DFS and OS appeared to be shorter in anxiety patients compared to nonanxiety patients at M0 but showed no statistical significance. However, DFS and OS were worse in depression patients compared to non-depression patients at M0. In conclusion, postoperative anxiety and depression are gradually worsened, relating to poor prognosis, and their main risk factors include female, single/divorced/widowed marry status, diabetes, hyperlipidemia, large tumor size, and high TNM stage in gastric cancer patients.