Effect of exercise, nutritional, and psychological interventions on postoperative nutritional and mental status of patients with esophageal cancer

doi:10.4240/wjgs.v17.i11.111233

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Nov 27, 2025 (publication date) through Nov 25, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Nov 27, 2025; 17(11): 111233
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.111233

Effect of exercise, nutritional, and psychological interventions on postoperative nutritional and mental status of patients with esophageal cancer

Shu-Hui Tang, Quan-Quan Cao, Xiao-Wan Xu, Mei-Juan Feng, Qi-Jue Lu, Jie Sun, Keng Zhong

Shu-Hui Tang, Mei-Juan Feng, Department of Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Quan-Quan Cao, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Xiao-Wan Xu, Traditional Chinese Medicine Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Qi-Jue Lu, Department of Cardiothoracic Surgery, Naval Characteristic Medical Center, Shanghai 200433, China

Jie Sun, Department of Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Keng Zhong, Department of Cardiovascular Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China

Co-first authors: Shu-Hui Tang and Quan-Quan Cao.

Co-corresponding authors: Jie Sun and Keng Zhong.

Author contributions: Tang SH and Cao QQ contributed equally to this article, they are the co-first authors of this manuscript; Tang SH, Cao QQ, and Xu XW designed the research study; Tang SH, Cao QQ, Xu XW, and Feng MJ collected and analyzed the data; Tang SH, Cao QQ, Xu XW, and Lu QJ has been involved in drafting the manuscript; Tang SH, Cao QQ, Xu XW, Feng MJ, Lu QJ, Sun J, and Zhong K performed the research, they have been involved in revising it critically for important intellectual content; Sun J and Zhong K contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.

Supported by the Special Project on Intravenous Therapy of Shanghai Nursing Society, No. 2023JL-B08; and Naval Medical University Nursing “Zhuyuan” Talent Program.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Naval Medical University.

Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at sunj136116@163.com. Participants gave informed consent for data sharing.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Jie Sun, Department of Nursing, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Shanghai 200433, China. sunj136116@163.com

Received: June 27, 2025
Revised: August 7, 2025
Accepted: October 9, 2025
Published online: November 27, 2025
Processing time: 150 Days and 19.9 Hours

Abstract

BACKGROUND

Esophageal cancer is a malignancy that originates in the epithelium of the esophageal mucosa and has a high mortality rate. Although radiotherapy is the primary treatment modality, it can easily lead to nutritional deterioration and psychological distress, affecting treatment efficacy and quality of life. Currently, there are relatively few postoperative rehabilitation interventions for esophageal cancer. As such, it is particularly important to develop a systematic and comprehensive intervention model to improve the quality of life and nutritional status of patients.

AIM

To evaluate exercise, nutritional, and psychological interventions on the postoperative nutritional and mental status of patients with esophageal cancer.

METHODS

Data from 104 patients, who were diagnosed with postoperative esophageal cancer between August 2023 and February 2024, were retrospectively analyzed. Patients were divided into 2 groups using a random numbers table: control [routine nursing measures (n = 53)]; and observation [routine nursing + exercise, nutritional support, and psychological interventions (n = 51)]. Nutritional status, anxiety and depression, quality of life, incidence of complications, treatment compliance, and satisfaction with nursing care were compared between the two groups.

RESULTS

Serum albumin, prealbumin, hemoglobin, transferrin, and World Health Organization Quality of Life-Brief Version scores were higher in the observation group than those in the control group. After treatment, Self-rating Anxiety Scale, Self-rating Depression Scale, and Hamilton Anxiety and Depression Scale scores in the observation group were lower than those in the control group. No significant differences were observed in the incidence of complications between the observation and control groups. The observation group exhibited more satisfaction with nursing care and treatment compliance than the control group.

CONCLUSION

Exercise, nutritional support, and psychological interventions effectively improves the nutritional status and negative emotions of patients undergoing radiotherapy for esophageal cancer, and enhances treatment compliance and satisfaction with nursing.

Keywords: Exercise intervention; Nutritional support; Psychological intervention; Esophageal cancer; Nutritional status and mental health

Core Tip: This retrospective study evaluated the effect of postoperative multimodal interventions (exercise, nutritional, and psychological support) combined with routine nursing in patients who underwent radiotherapy for esophageal cancer between August 2023 and February 2024. Data from 104 patients were divided into two groups: Control (routine nursing); and observation (multimodal intervention). The intervention group exhibited significantly improved nutritional status (higher albumin, prealbumin, hemoglobin, and transferrin levels), reduced anxiety and depression (lower scores on validated assessment tools), enhanced quality of life, and greater satisfaction with nursing and treatment compliance compared with the control group. This multimodal approach ameliorated nutrition-related decline and psychological distress.