Psychological Distress in Patients Treated for Renal Cell Carcinoma: A Systematic Literature Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol
2.2. Inclusion and Exclusion Criteria
2.3. Study Quality and Risk of Bias Evaluation
3. Results
3.1. Psychological Distress, Anxiety and/or Depression in Patients with Non-Metastatic Renal Cell Carcinoma
3.2. Impact of Anxiety and/or Depression on Oncological Outcomes in Patients with Non-Metastatic Renal Cell Carcinoma
3.3. Impact of Psychological Distress, Anxiety and/or Depression on Patients with Metastatic Renal Cell Carcinoma
No. | First Author | Year | Country | Study Design | No. Patients | Patients Characteristics | Questionnaires | Results | Follow-Up |
---|---|---|---|---|---|---|---|---|---|
1 | Bergerot et al. | 2019 [29] | United States of America | retrospective | 102 29 females (28.4%) | age ≥ 18 years, had histologically confirmed RCC, and had radiographic evidence of metastatic disease. | A touch screen–based instrument was used to assess biopsychosocial problem-related distress. The instrument surveyed 22 core items on a 5-point Likert scale ranging from 1 (not a problem) to 5 (very severe problem). Items rated ≥3 were considered to reflect high distress. | The median OS was 43.7 months (95% confidence interval [95%CI] = 35.5, 52.5) for the overall cohort; 20.0 months (95%CI = 16.0, 55.9) in patients with high distress, and 45.8 months (95%CI = 36.1, 55.5) in those with low distress (p = 0.81). | n.a |
2 | Wang et al. | 2018 [31] | China | prospective | 127 26 females (20.4%) | (I) diagnosed as mRCC according to clinical, imaging and pathological findings; (II) age above 18 years; (III) about to receive IFN-α treatment; (IV) life expectancy longer than 12 months; (V) able to be followed up regularly and complete the assessment questionnaires. Patients were excluded if they (I) had brain metastasis; (II) accompanied with other solid tumors or hematological malignance; (III) had uncontrolled hypertension, severe infection or primary organ failure; (IV) were pregnant or lactating, or planned for pregnancy | HADS-Anxiety score, HADS-Depression score and EORTC QLQ-C30 Scale at baseline and at 12 weeks | The percentages of anxiety and depression both increased at W12 compared with W0. Depression (43.3% vs. 31.5%, p = 0.004) and anxiety (32.3% vs. 22%, p = 0.035) | 12 weeks |
3 | Cohen et al. | 2012 [30] | United States of America | prospective | 202 46 females (23%) | newly diagnosed metastatic RCC, a life expectancy of greater than 4 months, a Zubrod performance status of less than or equal to 2, and no serious intercurrent illnesses. | (Centers for Epidemiologic Studies—Depression; SF-36 Health Status Survey; Duke Social Support Index; Coping Operations Preference Enquiry | CES-D scores (p = 0.05, HR = 1.5, 95%CI for HR: 1.00–2.23) were predictors for decrease survival | 1.8 years |
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No. | First Author | Year | Country | Study Design | No. Patients | Patients Characteristics | Treatment | Questionnaires | Results | Follow-Up |
---|---|---|---|---|---|---|---|---|---|---|
1 | Demirtaş et al. | 2021 [18] | Turkey | Cross-sectional | 250 (66 females 27%) | Kidney cancer | surgery had 102 patients (40.8%) type of surgery n.a | Hospital Depression and Anxiety Scale (HADS), and Perceived Stress Scale (PSS) | HADS-Anxiety symptoms in the study were found in 91.2% patients; 98 (39.2%) participants had mild, 99 (39.6%) had moderate, 31 (12.4%) had severe anxiety symptoms. HADS-Depression symptoms were found in 87.2% patients; 87 (34.8%) participants had mild, 101 (40.4%) had moderate, 30 (12%) had severe depression symptoms. | None Evaluation some time (n.a) after treatment |
2 | Ajaj et al. | 2020 [19] | Canada | Retrospective 2014–2017 | 495 (184 females 37.2%) | Consecutive patients diagnosed with non-metastatic RCC | PN 93 females (62.8%) vs. 148 males (61.7%) | The Edmonton Symptom Assessment System—revised (ESAS-r) | Increasing age was shown to be associated with a lower Psychological distress sub-score (PDSS) score after diagnosis [B = −0.135, 95%CI −0.238 to (−0.032), p = 0.011] and after nephrectomy [B = −0.078, 95%CI −0.139 to (−0.018), p = 0.012]. PDSS was significantly higher in females after diagnosis (8.5 vs. 5.1, p = 0.018), after biopsy (8.9 vs. 4.1, p = 0.003), and after surgery (6.5 vs. 4.4, p = 0.007), while there was no difference at the last follow-up (5.9 vs. 5, p = 0.379). | None Evaluation at 37 mo. for females and 26 mo. for males after treatment |
3 | Shin et al. | 2019 [20] | Korea | Case-control between April 2014 and December 2015 | 108 (31 females 28.7%) | non-metastatic RCC | n.a | European Organization for Research and Treatment of Cancer QLQ-C30, the Duke-UNC Functional Social Support Questionnaire and the Patient Health Questionnaire-9. | At 2 years no statistically significant difference was observed in terms of depressive symptoms between kidney cancer survivors and the general population. | None Evaluation at least 1 year after surgery |
4 | Bergerot et al. | 2019 [21] | USA | Online survey from 1 April to 15 June 2017 | 450 (224 females 56%) | non-metastatic RCC (74%) | n.a | NCCN Distress Thermometer (NCCN-DT) | 77 % of patients reported moderate-to-severe distress. Distress was significantly associated with female gender, younger age, non-clear cell histology and presence of recurrence | None Evaluation some time (n.a) after treatment |
5 | Draeger et al. | 2018 [22] | Germany | Cross-sectional | 74 (20 females 27%) | Consecutive RCC patients irrespective of tumor stage (localized versus advanced) 71 were N0M0 | 71 RN | [NCCN Distress Thermometer (NCCN-DT), Hornheider Screening Instrument (HSI)] | The main identified stressors were anxiety (28%), pain (27%), nervousness (26%), sadness (20%), sorrow (20%) and sleep difficulties (20%) | None Evaluation at time of treatment |
6 | Li et al. | 2016 [23] | China | Cross-sectional from July 2013 to July 2014 | 268 (100 females 37.3%) | Kidney cancer stage I-III (mostly non-metastatic RCC) | n.a | Center for Epidemiologic Studies Depression Scale (CES-D), Zung Self-Rating Anxiety Scale, Resilience Scale-14, and Perceived Stress Scale-10 | The prevalence of depressive and anxiety symptoms was 77.6% and 68.3% in renal cancer patients. | None Evaluation one week after surgery |
7 | Thekdi et al. | 2016 [24] | USA | Baseline data of a randomized controlled trial evaluating the benefits of an expressive writing intervention on quality of life outcomes | 287 (118 females 42%) | Kidney cancer Stage I-IV (mostly non-metastatic RCC) | Surgery 195 (70.3) | CES-D, Impact of Events Scale (IES), MD Anderson Symptom Inventory (MDASI), Brief Fatigue Inventory (BFI) and Pittsburgh Sleep Quality Index (PSQI) | 15.2% were identified as having comorbid (Post-traumatic Stress Symptoms) PTSS and depressive symptoms; 24.1% PTSS alone; 5.9% depressive symptoms alone | None Evaluation before treatment |
8 | Ames et al. | 2011 [16] | USA | Prospective between October 2005 and January 2008 | 28 (8 females 29%) | localized RCC | RN | The Functional Assessment of Cancer Therapy–General (FACT-G), Medical Outcomes Study 36-item short form survey (SF-36), The Profile of Mood States–Brief (POMS-B), Beck Depression Inventory–II (BDI-II), State-Trait Anxiety Inventory (STAI) prior to nephrectomy and at 4, 12, and 24 weeks post-nephrectomy and completion of individual semi-structured interviews 4 weeks post-nephrectomy | No significant change was observed in BDI –II scores: 5.5 (4.8) baseline vs. 8.7 (9.7) at 24 weeks, p = 0.081 No significant change was observed in STAI scores at baseline 34.9 (12.9) vs. 32.1 (8.9) at 24 weeks, p = 0.25 | Evaluation at baseline and at 24 weeks after treatment |
9 | Anastasiadis et al. | 2003 [25] | USA | Cross-sectional survey of a random sample of patients | 84 (42 females 50%) | Kidney cancer | RN (up to 90%) | Watts Sexual Function Questionnaire (WSFQ), the SF-12 Health Survey, CES-D, and the Revised Dyadic Adjustment Scale | 51% of men and 57% of women reported depressive symptoms (CES-D > 16) at more than 3 years after diagnosis | None Evaluation at 3.2 years for females and 3.7 years for males after treatment |
10 | Ficarra et al. | 2002 [26] | Italy | Cross-sectional | 144 (48 females 33.3%) | T1N0M0 RCC | 56 patients (39%) have been treated with elective NSS and 88 (61%) underwent RN | General Health Questionnaire (GHQ), HADS, Social Problem Questionnaire (SPQ.) | Higher scores for anxiety 2.77 ± 2.77 vs. 1.79 ± 2.47, p = 0.003 and depression 2.08 ± 2.32 vs. 1.70 ± 2.80 p = 0.015 were reported in the RN group compared to those that underwent NSS | None Evaluation at 55 ± 36 months after treatment |
No. | First Author | Year | Country | Study Design | No. Patients | Patients Characteristics | Treatment | Questionnaires | Results | Follow-Up |
---|---|---|---|---|---|---|---|---|---|---|
1 | Packiam et al. | 2020 [27] | USA | Retrospective between 1995 and 2011 | 1990 (701 females 35%) | non-metastatic RCC | RN 1144 (57%) | Baseline anxiety and depression were identified using ICD-9 Codes (197 patients with anxiety and/or depression) | No significant differences were noted regarding local ipsilateral recurrence, distant metastases, overall survival or death from RCC between patients with vs. without anxiety or depression. | 10 years |
2 | Song et al. | 2018 [28] | China | Randomized clinical trial | 182 | RCC patients were randomly allocated 1:1 in two groups intensive patients’ care program IPCP group (IPCP plus usual care) or a control group (only usual care) (I) diagnosed as RCC according to clinical, imaging and pathological findings; (II) age above 18 years; (III) unilateral renal cell carcinoma; (IV) received radical nephrectomy; (V) able to complete the questionnaire of assessments. | RN | Hospital Anxiety and Depression Scale anxiety/ depression (HADS-A/HADS-D) Zung Self Rating Anxiety/Depression Scale (SAS/SDS) Evaluation at baseline and at 12 months after treatment | Patients with sustained anxiety assessed by the HADS-A score had worse OS compared with that of patients without sustained anxiety assessed by HADS-A score (p = 0.026). Patients with sustained anxiety assessed by SDS score also had a shorter OS compared with patients without sustained anxiety assessed by SAS score (p = 0.012). No difference of OS between patients with or without depression assessed by HADS-D score (p = 0.166) or SDS score (p = 0.131) | 43 mo. |
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Vartolomei, L.; Schmidinger, M.; Vartolomei, M.D.; Shariat, S.F. Psychological Distress in Patients Treated for Renal Cell Carcinoma: A Systematic Literature Review. J. Clin. Med. 2022, 11, 6383. https://doi.org/10.3390/jcm11216383
Vartolomei L, Schmidinger M, Vartolomei MD, Shariat SF. Psychological Distress in Patients Treated for Renal Cell Carcinoma: A Systematic Literature Review. Journal of Clinical Medicine. 2022; 11(21):6383. https://doi.org/10.3390/jcm11216383
Chicago/Turabian StyleVartolomei, Liliana, Manuela Schmidinger, Mihai Dorin Vartolomei, and Shahrokh F. Shariat. 2022. "Psychological Distress in Patients Treated for Renal Cell Carcinoma: A Systematic Literature Review" Journal of Clinical Medicine 11, no. 21: 6383. https://doi.org/10.3390/jcm11216383
APA StyleVartolomei, L., Schmidinger, M., Vartolomei, M. D., & Shariat, S. F. (2022). Psychological Distress in Patients Treated for Renal Cell Carcinoma: A Systematic Literature Review. Journal of Clinical Medicine, 11(21), 6383. https://doi.org/10.3390/jcm11216383