Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 106026
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106026
Fear of cancer recurrence and influencing factors in elderly patients with gastric cancer undergoing laparoscopic radical surgery
Nai-Geng Zhu, Dong-Dong Zhao, Heng Cui, Sheng-Hong Sun
Nai-Geng Zhu, Dong-Dong Zhao, Heng Cui, Sheng-Hong Sun, Department of Medical, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Co-first authors: Nai-Geng Zhu and Dong-Dong Zhao.
Author contributions: Zhu NG contributed to the research design, data collection, statistical analysis, and manuscript drafting; Zhao DD, Cui H, and Sun SH participated in data analysis, interpretation, and critical revisions of the manuscript; All authors reviewed and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. PJ 2024-13-56).
Informed consent statement: All patients voluntarily signed informed consent forms.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author (Zhu NG) upon reasonable request.
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: Nai-Geng Zhu, MD, Doctor, Department of Medical, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. zng2024001@163.com
Received: February 18, 2025
Revised: March 25, 2025
Accepted: May 23, 2025
Published online: July 27, 2025
Processing time: 155 Days and 3.4 Hours
Abstract
BACKGROUND

Fear of cancer recurrence (FCR) is a common psychological problem among patients with cancer, especially elderly patients. For patients with gastric cancer (GC) who have undergone treatments such as surgery, FCR may seriously affect their quality of life and psychological well-being.

AIM

To evaluate the FCR in elderly patients with GC undergoing laparoscopic radical surgery in Hefei City and to explore its related influencing factors.

METHODS

In this study 264 elderly patients with GC who underwent laparoscopic radical surgery in four hospital districts of The First Affiliated Hospital of Anhui Medical University from June 2021 to January 2024 were recruited. Information on basic characteristics, disease characteristics, psychological status, and social support was collected by a questionnaire. In statistical analysis, the t-test and χ2 test were used to analyze the differences between groups. The influencing factors of FCR were analyzed by logistic regression. Based on these influencing factors, a nomogram model was initially constructed to identify patients with GC with high FCR risk.

RESULTS

Elderly patients with GC generally faced higher FCR levels after laparoscopic radical surgery. Among the 264 patients, 168 had clinical symptoms of FCR, and the prevalence rate was 63.64%. Further analysis showed that older age, high mental resilience, and sufficient social support were favorable factors for reducing FCR level, while heavier self-perceived burden, low education level, shorter duration of disease, larger tumor diameter, and more complications were associated with a higher FCR level.

CONCLUSION

This study demonstrated the significance of psychological interventions and social support strategies in reducing FCR among elderly patients with GC. In the future treatment protocols should be further optimized, and psychological and social support should be enhanced to improve the quality of life for this patient population.

Keywords: Gastric cancer; Fear of cancer recurrence; The elderly; Laparoscopic radical surgery; Influencing factors

Core Tip: This study investigated the fear of cancer recurrence (FCR) in elderly patients with gastric cancer after laparoscopic radical surgery and identified key influencing factors. Among 264 patients, 63.64% exhibited clinically significant FCR. Protective factors included older age, higher psychological resilience, and social support, while risk factors were higher self-perceived burden, lower education, shorter disease duration, larger tumor diameter, and complications. A nomogram model was constructed to predict FCR risk, highlighting the importance of psychological and social support in improving patient quality of life.