Abstract
Background
Cancer patients experience anxiety and depression after diagnosis and during treatment. A wide range of psychological interventions have been proposed to alleviate distress, but the evidence about the perioperative effectiveness of such interventions is not clear. This systematic review examined the effect of preoperative psychological interventions or prehabilitation on the postoperative outcomes of patients undergoing surgery for cancer.
Methods
A systematic review of the published data was performed using Embase, Medline, and PsycInfo for the period from 1946 to February 2014. A total of 951 publications (case series, single case reports, and reviews) were found. Only seven of these studies included patients undergoing an operation for cancer and a preoperative psychological intervention.
Results
Six of the seven studies were randomized controlled trials. Four were conducted with patients who had breast cancer (n = 356). The other studies included patients with gynecologic cancer (n = 30), colorectal cancer (n = 60), and prostate cancer (n = 159). Assessment of the studies showed four to be of good quality, two to be of moderate quality, and one to be of poor quality. Interventions did not affect traditional surgical outcomes (e.g., length of hospital stay, complications, analgesia use, or mortality) but positively affected patients’ immunologic function. However, psychological interventions appeared to have an impact on patients’ reported outcome measures including psychological outcomes, quality of life, and somatic symptoms.
Conclusion
Available data suggested that preoperative psychological prehabilitation may have a role for cancer patients undergoing surgery. Further evidence is needed to evaluate its role.
Cancer patients experience anxiety and depression after diagnosis and during treatment. A wide range of psychological interventions have been proposed to alleviate distress, but the evidence about the perioperative effectiveness of such interventions is not clear. This systematic review examined the effect of preoperative psychological interventions or prehabilitation on the postoperative outcomes of patients undergoing surgery for cancer.
Methods
A systematic review of the published data was performed using Embase, Medline, and PsycInfo for the period from 1946 to February 2014. A total of 951 publications (case series, single case reports, and reviews) were found. Only seven of these studies included patients undergoing an operation for cancer and a preoperative psychological intervention.
Results
Six of the seven studies were randomized controlled trials. Four were conducted with patients who had breast cancer (n = 356). The other studies included patients with gynecologic cancer (n = 30), colorectal cancer (n = 60), and prostate cancer (n = 159). Assessment of the studies showed four to be of good quality, two to be of moderate quality, and one to be of poor quality. Interventions did not affect traditional surgical outcomes (e.g., length of hospital stay, complications, analgesia use, or mortality) but positively affected patients’ immunologic function. However, psychological interventions appeared to have an impact on patients’ reported outcome measures including psychological outcomes, quality of life, and somatic symptoms.
Conclusion
Available data suggested that preoperative psychological prehabilitation may have a role for cancer patients undergoing surgery. Further evidence is needed to evaluate its role.
| Original language | English |
|---|---|
| Pages (from-to) | 4117-4123 |
| Journal | Annals of Surgical Oncology |
| Volume | 22 |
| Issue number | 13 |
| Early online date | 14 Apr 2015 |
| DOIs | |
| Publication status | Published - Dec 2015 |
