Preoperative Anxiety and Depression Symptoms Stratifying Based on Gender Differences Influence Outcome of Oral Squamous Cell Carcinoma.

Abstract

The objective of this study is to investigate the impact of preoperative anxiety symptoms (AS) and depression symptoms (DS) on clinical outcomes and time to treatment initiation (TTI) of oral squamous cell carcinoma (OSCC). Seven hundred and twenty-five OSCC patients were included. Kaplan-Meier and Cox models analyzed hazard ratio (HR) for survival, while accelerated failure time models estimated time ratio (TR) for TTI. Females showed higher prevalence and severity of AS (p = 0.014) and DS (p = 0.002). Mild AS (HR: 2.132, 95% CI: 1.091-4.165; p = 0.027) and DS (HR: 2.061, 95% CI: 1.052-4.038; p = 0.035) increased mortality risk in females. Mild DS prolonged TTI in females (TR: 1.450, 95% CI: 1.001-2.099; p = 0.049). Males with mild DS (TR: 0.718, 95% CI: 0.549-0.940; p = 0.016) or moderate-severe AS (TR: 0.562, 95% CI: 0.382-0.826; p = 0.003) had reduced TTI. Psychological distress impacts survival and TTI differently by gender.