Cui BY, Zhang Z. Impact of anxiety and depression on quality of life in gastric cancer patients receiving SOX neoadjuvant chemotherapy. World J Gastrointest Oncol 2026; 18(7): 119170 [DOI: 10.4251/wjgo.v18.i7.119170]
Corresponding Author of This Article
Zhen Zhang, Lecturer, Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Wuhua District, Kunming 650000, Yunnan Province, China. 15987129313@163.com
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Ophthalmology
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Cui BY, Zhang Z. Impact of anxiety and depression on quality of life in gastric cancer patients receiving SOX neoadjuvant chemotherapy. World J Gastrointest Oncol 2026; 18(7): 119170 [DOI: 10.4251/wjgo.v18.i7.119170]
World J Gastrointest Oncol. Jul 15, 2026; 18(7): 119170 Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.119170
Impact of anxiety and depression on quality of life in gastric cancer patients receiving SOX neoadjuvant chemotherapy
Bo-Yang Cui, Zhen Zhang
Bo-Yang Cui, School of Psychology, Fujian Normal University, Fuzhou 350000, Fujian Province, China
Zhen Zhang, Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan Province, China
Author contributions: Cui BY and Zhang Z contributed to the study conception and design; Zhang Z performed analysis, material preparation, data collection; Cui BY was written the first draft of the manuscript. Cui BY and Zhang Z critically revised and approved the final version of the manuscript.
AI contribution statement: In this manuscript, we only use Grammarly and DeepL for English polishing and translation assistance. No AI tools were used to generate any parts of the main text, design research, interpret results, or generate images.
Institutional review board statement: This study was reviewed and approved by Medical Ethics Committee of the Second Affiliated Hospital of Kunming Medical University.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: No conflict of interest is associated with this work.
Data sharing statement: No other data available.
Corresponding author: Zhen Zhang, Lecturer, Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Wuhua District, Kunming 650000, Yunnan Province, China. 15987129313@163.com
Received: January 20, 2026 Revised: February 3, 2026 Accepted: March 10, 2026 Published online: July 15, 2026 Processing time: 166 Days and 17.9 Hours
Abstract
BACKGROUND
Gastric cancer (GC) is a leading cause of cancer mortality globally. The SOX neoadjuvant chemotherapy regimen is standard for early-to-mid-stage disease, but chemotherapy-related stress often induces psychological distress.
AIM
To investigate the prevalence, risk factors of anxiety and depression in stage II-III GC patients receiving SOX neoadjuvant chemotherapy, and clarify their independent impacts on quality of life (QoL).
METHODS
A retrospective analysis was conducted on 153 patients with stage II-III GC receiving SOX regimen NACT at The Second Affiliated Hospital of Kunming Medical University Hospital. Anxiety and depression were assessed using the Zung Self-Rating Anxiety (SAS) and Zung Self-Rating Depression Scale (SDS) scales. QoL was evaluated with the QoL Questionnaire Core 30 questionnaire. Demographic, clinical data, and adverse reactions were collected. Multivariate logistic regression identified risk factors for anxiety/depression. Multiple linear regression analyzed the independent impact of psychological distress on global QoL.
RESULTS
The prevalence of anxiety (SAS ≥ 50) and depression (SDS ≥ 53) was 37.91% (58/153) and 39.87% (61/153), respectively; 47.71% (73/153) had either symptom (anxiety-depression group). Independent risk factors for anxiety/depression included female gender [odds ratio (OR) = 2.13, 95% confidence interval (CI): 1.03-4.40], unmarried/divorced/widowed status (OR = 3.17, 95%CI: 1.28-7.85), primary school education or below (OR = 3.50, 95%CI: 1.33-9.21), and clinical stage III (OR = 2.69, 95%CI: 1.32-5.46). The anxiety-depression group had higher Grade III–IV gastrointestinal reactions (20.55% vs 8.75%, P = 0.021). SAS/SDS scores negatively correlated with emotional (r = -0.552/-0.599), social (r = -0.403/-0.471), physical functioning (r = -0.369/-0.404), and global QoL (r = -0.539/-0.574, all P < 0.001). After adjusting confounders, anxiety (β = -0.12, P = 0.013) and depression (β = -0.14, P < 0.001) independently predicted lower global QoL.
CONCLUSION
Anxiety and depression are common in early-to-mid-stage GC patients receiving SOX neoadjuvant chemotherapy, associated with specific demographic/clinical factors, severe gastrointestinal reactions, and poor QoL, highlighting the need for routine psychological screening and intervention.
Core Tip: This study reveals that nearly half of the patients with early-to-mid-stage gastric cancer undergoing neoadjuvant chemotherapy experience anxiety or depression. These conditions are more common in females, those without spousal support, the less educated, and those with advanced-stage disease. Critically, psychological distress is independently linked to more severe gastrointestinal reactions and a significantly poorer quality of life. Our findings underscore the urgent need for integrating routine psychological screening and support into the standard management protocol for these patients to address both mental and physical well-being.
