Purpose

The interplay between physical and mental aspects of a cancer diagnosis are well recognised. However, little consensus exists on the impact of depression and anxiety on urological cancer outcomes. Therefore, this systematic review aimed to investigate the relationship between these conditions and functional or oncological outcomes in urological malignancy.

Materials and Methods

A systematic search was conducted using PubMed, Embase, PsycINFO and Global Health databases up to June 2020. Studies evaluating the relationship of anxiety and depression disorders or symptoms on functional and mortality outcomes were included. Outcome measures included validated urinary, sexual, body image questionnaire scores and all-cause or disease-specific mortality.

Results

Of 3,966 studies screened, 25 studies with a total of 175,047 urological cancer patients were included. Significant anxiety and depressive symptoms and disorders were found to impact functional outcomes in several cancer types. A consistent negative association existed for sexual function in prostate, testicular and penile cancer patients. Additionally, poorer urinary function scores were seen in prostate cancer, with increased body image issues in testicular and prostate cancer. Importantly, both overall and disease-specific mortality outcomes were poorer in bladder and prostate cancer patients.

Conclusions

Co-existing depression and anxiety appears to be negatively associated with functional and mortality outcomes in urological cancers. This appears especially evident in male cancers, including prostate and testicular cancer. Although not proving causation, these findings highlight the importance of considering mental wellbeing during follow-up for early recognition and treatment. However, current evidence remains heterogenous, with further studies required exploring patients at risk.

中文翻译：

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焦虑、抑郁和泌尿系统癌症结局：系统评价

目的

癌症诊断的身体和心理方面之间的相互作用是公认的。然而，关于抑郁和焦虑对泌尿系统癌症结局的影响几乎没有达成共识。因此，本系统评价旨在调查这些情况与泌尿系统恶性肿瘤的功能或肿瘤学结果之间的关系。

材料和方法

截至 2020 年 6 月，使用 PubMed、Embase、PsycINFO 和全球健康数据库进行了系统搜索。包括评估焦虑和抑郁障碍或症状与功能和死亡率结果之间关系的研究。结果测量包括经过验证的泌尿、性、身体形象问卷评分和全因或疾病特异性死亡率。

结果

在筛选的 3,966 项研究中，纳入了 25 项研究，共有 175,047 名泌尿系统癌症患者。发现显着的焦虑和抑郁症状和障碍会影响几种癌症类型的功能结果。前列腺癌、睾丸癌和阴茎癌患者的性功能始终呈负相关。此外，前列腺癌的泌尿功能评分较差，睾丸癌和前列腺癌的身体形象问题增加。重要的是，膀胱癌和前列腺癌患者的总体死亡率和疾病特异性死亡率结果均较差。

结论

共存的抑郁和焦虑似乎与泌尿系统癌症的功能和死亡率结果呈负相关。这在男性癌症中尤其明显，包括前列腺癌和睾丸癌。尽管没有证明因果关系，但这些发现强调了在随访期间考虑心理健康以进行早期识别和治疗的重要性。然而，目前的证据仍然存在异质性，需要进一步研究探索有风险的患者。