Association of Postoperative Antidepressant and Anxiolytic Exposure With Overall Survival Following Radical Cystectomy for Bladder Cancer.

IF 3.9 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2026-08-01 DOI:10.1002/pon.70581

Cheng-Shuo Huang, Kai-Hsiang Tung, Ying-Si Wu, Cheng-Ping Yu, Dah-Shyong Yu, Ming-Hsin Yang, Yong-Eng Lee, Jar-Yi Ho

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引用次数: 0

Abstract

Background: Psychological distress is an important component of cancer survivorship, particularly among patients undergoing radical cystectomy (RC) for bladder cancer. However, the prognostic significance of postoperative psychiatric medication exposure following RC remains unclear.

Aims: To investigate the association between postoperative antidepressant and/or anxiolytic exposure and survival outcomes following RC for bladder cancer.

Methods: This retrospective propensity score-matched cohort study used data from the TriNetX US Collaborative Network. Adult patients who underwent RC for bladder cancer (2005-2025) were identified. Postoperative psychiatric medication exposure was defined as new use of antidepressants (Anatomical Therapeutic Chemical: N06A) and/or anxiolytics (ATC: N05B). The primary analysis evaluated combined antidepressant/anxiolytic exposure, with separate antidepressant-only and anxiolytic-only subgroup analyses. Overall survival (OS) and all-cause mortality were evaluated after 1:1 propensity score matching (PSM).

Results: The primary analysis identified 2461 exposed and 7257 unexposed patients, yielding 1521 matched pairs after PSM. Patients exposed to postoperative psychiatric medication were associated with significantly poorer OS than their matched controls (hazard ratio [HR]: 1.377, 95% confidence interval [CI]: 1.261-1.502; log-rank p < 0.001). Similar associations were observed in subgroup analyses. Antidepressant-only exposure was associated with poorer OS (HR: 1.260, 95% CI: 1.161-1.367; p < 0.001), and the anxiolytic-only subgroup demonstrated the strongest association with poorer survival (HR: 1.457, 95% CI: 1.324-1.604; p < 0.001).

Conclusions: Psychiatric medication use may represent a clinically observable marker of psychological burden and survivorship vulnerability following RC. Early recognition of postoperative psychological vulnerability may facilitate timely psycho-oncological support and multidisciplinary survivorship care following RC.

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膀胱癌根治性膀胱切除术后抗抑郁药和抗焦虑药暴露与总生存率的关系。

背景：心理困扰是癌症生存的重要组成部分，特别是在接受根治性膀胱切除术（RC）的膀胱癌患者中。然而，RC术后精神药物暴露的预后意义尚不清楚。目的：探讨膀胱癌术后抗抑郁药和/或抗焦虑药暴露与RC术后生存结局之间的关系。方法：这项回顾性倾向评分匹配队列研究使用来自TriNetX美国协作网络的数据。研究对象为2005-2025年间膀胱癌行RC治疗的成年患者。术后精神科药物暴露定义为新使用抗抑郁药（解剖治疗化学：N06A）和/或抗焦虑药（ATC: N05B）。初步分析评估了抗抑郁药/抗焦虑药的联合暴露，并进行了单独的抗抑郁药和抗焦虑药亚组分析。在1:1倾向评分匹配（PSM）后评估总生存率（OS）和全因死亡率。结果：初步分析鉴定了2461例暴露患者和7257例未暴露患者，得到1521对PSM后的匹配结果。术后接受精神药物治疗的患者的OS明显低于对照组（风险比[HR]: 1.377, 95%可信区间[CI]: 1.261-1.502; log-rank p）。结论：精神药物的使用可能是临床观察到的RC后心理负担和生存脆弱性的标志。早期识别术后心理脆弱性有助于术后及时的心理肿瘤支持和多学科生存护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.