关键词: 结直肠癌, 症状轨迹, 纵向研究, 老年

Abstract:

Objective： To investigate and explore the symptom trajectories of elderly colorectal cancer patients from the perioperative period through chemotherapy， and to analyze the relevant factors affection the development of the symptoms.Methods： A total of 242 elderly CRC patients who underwent elective surgery in the gastrointestinal surgery department of a tertiary hospital in Shanghai between January 2023 and May 2024 were enrolled. Disease-related data were collected， and multidimensional assessments were conducted using the MD Anderson symptom inventory （MDASI）， Groningen frailty indicator （GFI）， hospital anxiety and depression scale （HADS）， mini-mental state examination （MMSE）， and perceived social support scale （PSSS） at four time points： one day before surgery （T0）， one week after the surgery （T1）， one month after the surgery （T2）， and three months after the surgery （T3）. Growth mixture modeling （GMM） was applied to identify distinct symptom trajectories， and binary Logistic regression was used to analyze the influencing factors.Results： Four symptom trajectories were identified： C1： Low-symptom stable group， C2： Low-symptom gradual increase group， C3： Low-symptom rapid progression group， C4： High-symptom decreasing group. Logistic regression revealed that female sex， pathological stages Ⅲ-Ⅳ， stoma formation， depression， cognitive impairment， and social support were independent influencing factors （P < 0.05）.Conclusion： The quality of life varies significantly among patients with different symptom trajectories. Healthcare professionals can use scientific tools to accurately predict symptom progression trends and provide cluster intervention measures， thereby alleviating the physical and psychological distress caused by symptoms in elderly colorectal cancer patients.

Key words:  , Colorectal cancer； , Symptom trajectory； , Longitudinal study； , Older adults