Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study
ABSTRACT Aims To examine the changing trajectories of symptom clusters within 3 months following surgery in patients with colorectal cancer (CRC) and identify their predictive factors. Design A prospective longitudinal observational study. Methods Convenience sampling was used to recruit inpatients...
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Wiley
2025-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.71025 |
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| author | Yue Li Wenwen Gan Qin Mao Hongying Wu Ting Cao Haiyan Wu Xiaorong Mao |
| author_facet | Yue Li Wenwen Gan Qin Mao Hongying Wu Ting Cao Haiyan Wu Xiaorong Mao |
| author_sort | Yue Li |
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| description | ABSTRACT Aims To examine the changing trajectories of symptom clusters within 3 months following surgery in patients with colorectal cancer (CRC) and identify their predictive factors. Design A prospective longitudinal observational study. Methods Convenience sampling was used to recruit inpatients with CRC who were scheduled for surgical treatment at the Sichuan Provincial People's Hospital between October 2022 and September 2023. The Chinese version of the MD Anderson Symptom Inventory Gastrointestinal Cancer Module was utilized. The prevalence and severity of patients' symptoms were assessed at 7 days (T1), 6 weeks (T2), and 3 months (T3). Before the operation, a total of 240 patients with CRC were recruited. There were 203, 164, and 139 patients participating in T1, T2, and T3, respectively. Exploratory factor analysis identified symptom clusters. Latent class growth modeling determined the developmental trajectories of symptom clusters, and binomial logistic regression analyzed predictors of trajectory classification. Results Two clinical subgroups were identified: a “high symptom—decreases and then increases” (17.2%) and a “low symptoms—continuous decline” (82.8%). The latter exhibited significantly lower and progressively declining symptom severity compared to the former. Predictive factors for the “high symptom—decreases and then increases” subgroup included multimorbidity (≥ 2 chronic conditions), chronic lung disease, preoperative frailty, severe anxiety/depression, open surgery, and postoperative chemotherapy. Conclusions Targeted management of the mood‐sleep disorder cluster (T1) and the activity intolerance cluster (T2/T3) may significantly improve patients' quality of life. The “high symptom—decreases then increases” subgroup warrants prioritized clinical attention, as early intervention for its predictive factors (e.g., frailty, anxiety, and depression) could enhance postoperative outcomes. Integrating these factors into routine preoperative assessments is recommended. |
| format | Article |
| id | doaj-art-780a3a53fa4546c9a332babaa034ef15 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-780a3a53fa4546c9a332babaa034ef152025-08-20T03:34:09ZengWileyCancer Medicine2045-76342025-07-011413n/an/a10.1002/cam4.71025Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal StudyYue Li0Wenwen Gan1Qin Mao2Hongying Wu3Ting Cao4Haiyan Wu5Xiaorong Mao6Department of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Nursing, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaABSTRACT Aims To examine the changing trajectories of symptom clusters within 3 months following surgery in patients with colorectal cancer (CRC) and identify their predictive factors. Design A prospective longitudinal observational study. Methods Convenience sampling was used to recruit inpatients with CRC who were scheduled for surgical treatment at the Sichuan Provincial People's Hospital between October 2022 and September 2023. The Chinese version of the MD Anderson Symptom Inventory Gastrointestinal Cancer Module was utilized. The prevalence and severity of patients' symptoms were assessed at 7 days (T1), 6 weeks (T2), and 3 months (T3). Before the operation, a total of 240 patients with CRC were recruited. There were 203, 164, and 139 patients participating in T1, T2, and T3, respectively. Exploratory factor analysis identified symptom clusters. Latent class growth modeling determined the developmental trajectories of symptom clusters, and binomial logistic regression analyzed predictors of trajectory classification. Results Two clinical subgroups were identified: a “high symptom—decreases and then increases” (17.2%) and a “low symptoms—continuous decline” (82.8%). The latter exhibited significantly lower and progressively declining symptom severity compared to the former. Predictive factors for the “high symptom—decreases and then increases” subgroup included multimorbidity (≥ 2 chronic conditions), chronic lung disease, preoperative frailty, severe anxiety/depression, open surgery, and postoperative chemotherapy. Conclusions Targeted management of the mood‐sleep disorder cluster (T1) and the activity intolerance cluster (T2/T3) may significantly improve patients' quality of life. The “high symptom—decreases then increases” subgroup warrants prioritized clinical attention, as early intervention for its predictive factors (e.g., frailty, anxiety, and depression) could enhance postoperative outcomes. Integrating these factors into routine preoperative assessments is recommended.https://doi.org/10.1002/cam4.71025colorectal neoplasmsconvalescencelongitudinal studiesperioperative periodpredictive factorssubgroup analysis |
| spellingShingle | Yue Li Wenwen Gan Qin Mao Hongying Wu Ting Cao Haiyan Wu Xiaorong Mao Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study Cancer Medicine colorectal neoplasms convalescence longitudinal studies perioperative period predictive factors subgroup analysis |
| title | Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study |
| title_full | Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study |
| title_fullStr | Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study |
| title_full_unstemmed | Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study |
| title_short | Trajectories of Symptom Clusters and Their Predictive Factors in Patients With Colorectal Cancer 3 Months After Surgery: A Longitudinal Study |
| title_sort | trajectories of symptom clusters and their predictive factors in patients with colorectal cancer 3 months after surgery a longitudinal study |
| topic | colorectal neoplasms convalescence longitudinal studies perioperative period predictive factors subgroup analysis |
| url | https://doi.org/10.1002/cam4.71025 |
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