Fear of cancer recurrence and influencing factors in elderly patients with gastric cancer undergoing laparoscopic radical surgery

Abstract

Background: Fear of cancer recurrence (FCR) is a common psychological problem among patients with cancer, especially elderly patients. For patients with gastric cancer (GC) who have undergone treatments such as surgery, FCR may seriously affect their quality of life and psychological well-being.

Aim: To evaluate the FCR in elderly patients with GC undergoing laparoscopic radical surgery in Hefei City and to explore its related influencing factors.

Methods: In this study 264 elderly patients with GC who underwent laparoscopic radical surgery in four hospital districts of The First Affiliated Hospital of Anhui Medical University from June 2021 to January 2024 were recruited. Information on basic characteristics, disease characteristics, psychological status, and social support was collected by a questionnaire. In statistical analysis, the t-test and χ ² test were used to analyze the differences between groups. The influencing factors of FCR were analyzed by logistic regression. Based on these influencing factors, a nomogram model was initially constructed to identify patients with GC with high FCR risk.

Results: Elderly patients with GC generally faced higher FCR levels after laparoscopic radical surgery. Among the 264 patients, 168 had clinical symptoms of FCR, and the prevalence rate was 63.64%. Further analysis showed that older age, high mental resilience, and sufficient social support were favorable factors for reducing FCR level, while heavier self-perceived burden, low education level, shorter duration of disease, larger tumor diameter, and more complications were associated with a higher FCR level.

Conclusion: This study demonstrated the significance of psychological interventions and social support strategies in reducing FCR among elderly patients with GC. In the future treatment protocols should be further optimized, and psychological and social support should be enhanced to improve the quality of life for this patient population.

Keywords: Fear of cancer recurrence; Gastric cancer; Influencing factors; Laparoscopic radical surgery; The elderly.

Figure 1

Nomogram prediction model.

Figure 2

Evaluation of predictive models. A: Receiver operating characteristic curve; B: Calibration curve; C: Decision curve analysis curve. AUC: Area under the curve; CI: Confidence interval.