• Annals of surgery · Sep 2023

    Association between Distress at Diagnosis and disease-free Survival Among Patients with Resectable Colon Cancer: A Large Cohort Study.

    • Jung Kyong Shin, Danbee Kang, Soohyun Kim, Youngeun Choi, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Juhee Cho, and Hee Cheol Kim.
    • Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    • Ann. Surg. 2023 Sep 1; 278 (3): e534e539e534-e539.

    ObjectiveThis study aimed to evaluate the association between distress at initial diagnosis and disease-free survival in patients with resectable colon cancer.Summary Background DataConsiderable research has examined the psychological impact of having a confirmed diagnosis of cancer, but relatively limited research has examined the impact of distress during the diagnostic phase on oncological outcomes.MethodsThis is a retrospective cohort study. We included newly diagnosed colon cancer patients who had resectable surgery and underwent distress screening between July 2014 and July 2021 (N=1,362). The Korean versions of the Distress Thermometer were used to assess distress and related problems. Patients were categorized into 3 groups based on distress score: low (<4), moderate (4-7), and severe (≥8). The primary outcome was disease-free survival.ResultsThe mean distress was 5.1 (SD=2.4) and 61%, and 15% of patients had moderate and severe distress at diagnosis, respectively. The severe distress group was more likely to report fear, sadness, and concerns regarding insurance/finance, work, and childcare than the low distress group. Compared with the low distress group, the severe distress group had worse disease-free survival (Hazard Ratio=1.84, 95% CI=1.03, 3.29). The association was more evident in patients with stage IV disease (Hazard Ratio=2.53, 95% CI=1.02, 6.25).ConclusionsA substantial number of patients with colon cancer experience distress at diagnosis, and severe distress has a negative impact on oncologic outcomes. Active monitoring and appropriate management of distress at diagnosis should be adopted at clinical settings.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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