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Gender-based psychological and physical distress differences in patients diagnosed with non-metastatic renal cell carcinoma

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Objectives

To analyze gender-based differences in distress symptoms in patients with non-metastatic renal cell carcinoma (RCC) at different stages of disease.

Methods

The Edmonton Symptom Assessment System—revised (ESAS-r) questionnaire includes a physical (PHSDSS) and a psychological distress sub-score (PDSS). The ESAS-r was used to measure psychological and physical distress symptoms in localized RCC patients in a major cancer referral center between 2014 and 2017 at four predefined time points: (a) diagnosis, (b) biopsy, (c) surgery, and (d) last follow-up. Results were gender stratified, and multivariable linear regression models were used to determine associations with increased sub-scores.

Results

Overall, 495 patients were included with 37.2% females. No significant gender differences were seen in mean age, relevant clinical parameters, and treatment. PDSS was significantly higher in females after diagnosis (8.5 vs. 5.1, p = 0.018), biopsy (8.9 vs. 4.1, p = 0.003), and surgery (6.5 vs. 4.4, p = 0.007), while being similar at the last follow-up. The multivariable model demonstrated a statistically significant association of female gender with higher PDSS after diagnosis (B = 3.755, 95% CI 0.761–6.750), biopsy (B = 6.076, 95% CI 2.701–9.451), and surgery (B = 1.974, 95% CI 0.406–3.542). PHSDSS was significantly higher in females after biopsy (10.0 vs. 5.7, p = 0.028) and surgery (8.6 vs. 6.1, p = 0.022). In the multivariable model, female gender conferred a higher PHSDSS only after surgery (B = 2.384, 95% CI 0.208–4.560).

Conclusions

Gender-associated psychological distress differences exist in non-metastatic RCC patients throughout treatment, while dissipating at last follow-up. Emphasis should be placed on screening for distress symptoms and providing psychological support continuously, particularly for female patients.

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Abbreviations

RCC:

Renal cell carcinoma

AS:

Active surveillance

DX:

Diagnosis

BX:

Biopsy

NX:

Nephrectomy

FW:

Follow-up

PDSS:

Psychological distress sub-score

PHSDSS:

Physical distress sub-score

ESAS-r:

Edmonton Symptom Assessment System-revised

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Funding

No disclosures. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada

    Rami Ajaj, Jaime Omar Herrera Cáceres, Christopher J. D. Wallis, Ardalan E. Ahmad, Ricardo Leao, Antonio Finelli, Neil Fleshner & Hanan Goldberg

  2. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Alejandro Berlin

  3. Techna Institute, University Health Network, Toronto, ON, Canada

    Alejandro Berlin

  4. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA

    Christopher J. D. Wallis

  5. Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA

    Thenappan Chandrasekar

  6. Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA

    Zachary Klaassen

  7. Georgia Cancer Center, Augusta, GA, USA

    Zachary Klaassen

  8. Department of Urology, SUNY Upstate Medical University, Syracuse, NY, USA

    Hanan Goldberg

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  1. Rami Ajaj
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Contributions

Design and conception: HG. Data collection and analysis: JOCH, RA, HG, TC, ZK, CJDW. Writing of manuscript: RA, HG. Editing and reviewing of the manuscript: TC, ZK, CJDW, AEA, RL, JOCH, AB, NF, AF.

Corresponding author

Correspondence to Hanan Goldberg.

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All authors report no conflict of interests.

Research involving human participants and/or animals

As this was a retrospective study, this study did not contain any contact with human participants or animals performed by any of the authors.

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As this was a retrospective study, no informed consent was required for this study by the internal review board.

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Ajaj, R., Cáceres, J.O.H., Berlin, A. et al. Gender-based psychological and physical distress differences in patients diagnosed with non-metastatic renal cell carcinoma. World J Urol 38, 2547–2554 (2020). https://doi.org/10.1007/s00345-019-03057-2

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  • DOI: https://doi.org/10.1007/s00345-019-03057-2

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