Eur J Surg Oncol. 2026 Mar 6;52(5):111740. doi: 10.1016/j.ejso.2026.111740. Online ahead of print.
ABSTRACT
BACKGROUND: This study aimed to identify psychosocial subtypes among gastric cancer (GC) patients and examine their associations with quality of life (QoL) and survival outcomes.
METHODS: A prospective cohort design was adopted, including 455 newly diagnosed GC patients admitted to the Union Hospital of Fujian Medical University between January 2023 and August 2024. Depressive symptoms and sleep quality were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI), respectively. QoL was evaluated using the EORTC QLQ-C30 and QLQ-STO22 questionnaires. Latent class analysis (LCA) was performed based on social support, depressive symptoms, and sleep quality to identify distinct psychosocial subtypes. Between-group QoL differences at 6 months were examined with pairwise comparisons adjusted for baseline QoL (ANCOVA).
RESULTS: Three psychosocial subtypes were identified: low-risk (37.6%), moderate-risk (40.4%), and high-risk (22.0%). At 6 months postoperatively, the low-risk group showed higher physical functioning than the high-risk group (94.02 ± 8.16 vs. 89.83 ± 14.10; P = 0.011) and higher cognitive functioning than the moderate-risk group (98.56 ± 3.68 vs. 96.08 ± 8.96; P = 0.001) on the EORTC QLQ-C30. Global health status/QoL was also higher in the low-risk group than in the moderate- and high-risk groups (68.47 ± 21.39 vs. 62.57 ± 22.95 vs. 61.89 ± 21.05; P = 0.023 and 0.027, respectively). Dysphagia symptom burden on the EORTC QLQ-STO22 was greater in the moderate- and high-risk groups than in the low-risk group (10.90 ± 11.54 and 11.71 ± 11.49 vs. 6.83 ± 10.17; P = 0.001 and 0.002, respectively). In multivariable Cox regression, the high-risk group had a higher risk of death than the low-risk group (HR = 3.95, 95% CI: 1.20-13.00; P = 0.024).
CONCLUSIONS: Psychosocial subtypes identified by LCA were associated with 6-month postoperative QoL, and the high-risk subtype was an independent predictor of overall survival among GC patients. Early identification of high-risk patients may facilitate precision supportive care and inform multidimensional interventions to improve both QoL and survival.
PMID:41832888 | DOI:10.1016/j.ejso.2026.111740
