High level of unmet needs and anxiety are associated with delayed initiation of adjuvant chemotherapy for colorectal can
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ORIGINAL ARTICLE
High level of unmet needs and anxiety are associated with delayed initiation of adjuvant chemotherapy for colorectal cancer patients Li Zhu 1 & Yi Xin Tong 1 & Xiang Shang Xu 1 & Ai Tang Xiao 1 & Yu Jie Zhang 1 & Sheng Zhang 1 Received: 22 October 2019 / Accepted: 28 January 2020 # The Author(s) 2020
Abstract Aims Adjuvant chemotherapy is recommended for patients with curatively resected colorectal cancer. The aim of this study is to evaluate the impact of unmet supportive care needs and anxiety on the initiation of postoperative adjuvant chemotherapy in colorectal cancer patients. Methods This is a retrospective study from a single tertiary referral hospital. Patients diagnosed with colorectal cancer who met the inclusion criteria were included. The Hospital Anxiety and Depression Scale (HADS) and modified 34-item Supportive Care Needs Survey (SCNS-SF34) were applied to assess patient’s anxiety level and unmet needs. The time intervals between initiation of adjuvant chemotherapy and operation were recorded. Factors associated with delayed initiation of chemotherapy were investigated in univariate and multivariate analysis. Results A total of 135 patients with colorectal cancer were included. In total, 16.3% (22/135) and 5.2% (7/135) reported symptoms of anxiety and depression. In multivariate analysis, low to moderate income status, postoperative complications, anxiety, and high level of unmet needs are independent risk factors for late initiation of chemotherapy. Conclusions Our findings showed that psychological problems such as anxiety and high unmet supportive needs are correlated with delayed initiation of adjuvant chemotherapy in colorectal cancer patients. Keywords Colorectal cancer . Adjuvant chemotherapy . Delay initiation of chemotherapy . Patient’s needs . Anxiety . Depression . SCNS-SF34 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05333-z) contains supplementary material, which is available to authorized users. * Sheng Zhang [email protected] Li Zhu [email protected] Yi Xin Tong [email protected] Xiang Shang Xu [email protected] Ai Tang Xiao [email protected] Yu Jie Zhang [email protected] 1
Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Ave, No, Wuhan 1095, China
Introduction Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer death in the world [1]. Surgery together with adjuvant chemotherapy (AC) remains the standard treatment for stage III colorectal cancer patients and selected stage II patients [2–4]. The recently updated National Comprehensive Cancer Network (NCCN) guidelines suggested that the optimal timing to initiate postoperative adjuvant chemotherapies should be in/between 4 and 8 weeks after operations [5]. A systematic and meta-analysis involving 15,410 colorectal patients demonstrated that a 4-week increment in time to adjuvant chemotherapy was associated with a 14% decrease i
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