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Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients

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Abstract

Objective

To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.

Methods

We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.

Results

Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91–.99], p = .029). Among the three dimensions, only “establishing rapport” (OR = .84, 95% CI = [.73–.98], p = .019) and the “emotional process” (OR = .85, 95% CI = [.74–.98], p = .022) predicted major complications.

Conclusions

Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period.

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Acknowledgements

We would like to thank all patients who participated in the study and also the clinicians who included their patients: Léonor Benhaim, Olivier Bouche, Frédéric Borie, Cécile Brigand, Nicolas Carrere, Denis Collet, Thierry Conroy, Jacques Jougon, Medhi Ouaissi, Brice Paquette, François Paye, Frédérique Peschaud, Christophe Penna, Denis Pezet, Marc Pocard, and Jean-Marc Regimbeau. Special thanks to Justine Lerooy and Christine Delaeter. We thank the Data Treatment Center for the administration of FREGAT database and the provision of data.

The membership list of the FREGAT Working Group

Hôpital Huriez, CHU Lille, Lille; (Guillaume Piessen, Anthony Turpin, Florence Renaud)

Centre Oscar Lambret, CLCC, Lille; (Farid Elhajbi, Williams Tessier)

Centre Hospitalier Lyon Sud, Pierre Benite; (Olivier Glehen, Benoit You, Delphine Vaudoyer)

Hôpital Croix-Rousse, Lyon; (Olivier Glehen, Benoit You, Delphine Vaudoyer)

Hôpital E Herriot, Lyon; (Olivier Glehen, Benoit You, Delphine Vaudoyer)

CHU Hôpital Nord, Marseille; (Xavier Benoit D’journo, Laetitia Dahan, Pascal Alexandre Thomas)

Institut Gustave Roussy, CCLC, Villejuif; (Leonor Benhaim, Diane Goere, Frédéric Dumont, Valérie Boige)

CHU Haut Leveque, chirurgie thoracique, Bordeaux; (Jacques Jougon)

CHU Haut Leveque, chirurgie viscérale Bordeaux; (Caroline Gronnier, Denis Collet, Eric Terrebonne, Damien Bourriez)

Hôpital Rangueil, CHU Toulouse; (Nicolas Carrere, Rosine Guimbaud, Guillaume Père)

CHU Strasbourg; (Cécile Brigand, Marlène Nguimpi-Tambou, Benoit Romain)

Hôpital St Eloi, CHU Montpellier; (Jean Michel Fabre, Régis Souche, Eric Assenat)

Institut du Cancer de Montpellier; (Antoine Adenis)

Hôpital St Antoine, Paris; (Thibault Voron, François Paye, Romain Cohen, Jérémie H Lefevre)

Hôpital Avicenne, Bobigny; (Jean-Marc Sabate, Thomas Aparicio)

Hôpital Kremlin Bicêtre; (Christophe Penna)

Hôpital Lariboisière, Paris; (Marc Pocard, Jean Marc Gornet, Clarisse Eveno)

Hôpital Ambroise Paré, Boulogne-Billancourt; (Frédérique Peschaud, Cindy Neuzillet)

CHU, Clermont Ferrand; (Johan Gagniere, Denis Pezet, Morgane Helyon)

Centre Jean Perrin, Clermont Ferrand; (Céline Benoit, Joseph Fabre)

CHU, Nîmes; (Fréderic Borie, Valérie Phoutthsang)

CHU, Nancy; (Adeline Germain)

Centre Alexis Vautrin, CLCC, Nancy; (Thierry Conroy, Frédéric Marchal)

CHU, Reims; (Olivier Bouche, Marine Perrier, Sophie Deguelte)

CHU, Dijon; (Antoine Drouillard, Côme Lepage, Paul Rat)

CHU, Amiens; (Jean Marc Regimbeau, Vincent Hautefeuille)

CHU, Limoges; (Muriel Mathonnet, Sophie Geyl, Niki Christou)

CHU, Nantes; (Nicolas Regenet, Tamara Mathysiak)

Centre F. Baclesse, CLCC, Caen; (Marie Pierre Galais)

CHU, Caen; (Gilles Lebreton)

CHU, Rouen; (Fréderic Di Fiore)

CHU, Grenoble; (Pierre-Yves Brichon, Victoire Granger)

CHU, Tours; (Medhi Ouaissi, Driffa Moussata, Nicolas Michot)

Hôpital Louis Mourier, Colombes; (David Moszkowicz, Simon Msika, Benoit Coffin)

CHU Rennes; (Damien Bergeat, Bernard Meunier, Astrid Lievre)

Hôpital Cochin, Paris; (Bertrand Dousset, Maximilien Barret)

Hôpital Saint Louis, Paris; (Jean Marc Gornet, Pierre Cattan)

CHU Jean Minjoz, Besançon; (Brice Paquette, Angélique Vienot, Pierre Mathieu)

Funding

This research was funded by the SIRIC (SIte de Recherche Intégrée sur le Cancer) ONCOLille, Grant INCa-DGOS-Inserm 6041. This study was supported by an INCa (Institut National du Cancer) doctoral grant awarded to Lucie Gehenne. FREGAT was funded with support from the Institut National du Cancer (INCa), and CHU de Lille is the sponsor of the FREGAT study.

Author information

Authors and Affiliations

  1. SCALab UMR CNRS 9193, University of Lille, Villeneuve D’AscqCedex, Rue du Barreau BP 60149, Lille, France

    Lucie Gehenne, Sophie Lelorain, Anne-Sophie Baudry & Véronique Christophe

  2. Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, F-59000, Lille, France

    Clarisse Eveno, Guillaume Piessen & Christophe Mariette

  3. UMR-S1277 - CANTHER Laboratory “Cancer Heterogeneity, Plasticity and Resistance to Therapies”, Lille, France

    Guillaume Piessen

  4. Department of General and Oncological Surgery, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin du grand Revoyet, 69310, Pierre-Bénite, France

    Olivier Glehen

  5. Department of Thoracic Surgery, Marseille Cancerology Research Center (CRCM), Aix-Marseille University, CNRS, INSERM, Marseille, France

    Xavier D’journo

  6. Department of Digestive Surgery, CHU Limoges, Limoges, France

    Muriel Mathonnet

  7. Department of Digestive Surgery, Nantes Hospital, Nantes, France

    Nicolas Regenet

  8. Department of Hepatobiliary and Digestive Surgery, CHU, Rennes, France

    Bernard Meunier

  9. Pôle Cancérologie et Spécialités médicales, Centre Hospitalier de Valenciennes, Valenciennes, France

    Anne-Sophie Baudry

Authors
  1. Lucie Gehenne
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  2. Sophie Lelorain
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  3. Clarisse Eveno
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  4. Guillaume Piessen
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  5. Christophe Mariette
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  6. Olivier Glehen
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  7. Xavier D’journo
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  8. Muriel Mathonnet
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  9. Nicolas Regenet
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  10. Bernard Meunier
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  11. Anne-Sophie Baudry
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  12. Véronique Christophe
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Consortia

The FREGAT Working Group

  • Antoine Adenis
  • , Thomas Aparicio
  • , Eric Assenat
  • , Maximilien Barret
  • , Leonor Benhaim
  • , Céline Benoit
  • , Damien Bergeat
  • , Valérie Boige
  • , Fréderic Borie
  • , Olivier Bouche
  • , Damien Bourriez
  • , Pierre-Yves Brichon
  • , Cécile Brigand
  • , Nicolas Carrere
  • , Pierre Cattan
  • , Niki Christou
  • , Benoit Coffin
  • , Romain Cohen
  • , Denis Collet
  • , Thierry Conroy
  • , Xavier Benoit D’journo
  • , Laetitia Dahan
  • , Sophie Deguelte
  • , Fréderic Di Fiore
  • , Bertrand Dousset
  • , Antoine Drouillard
  • , Frédéric Dumont
  • , Farid Elhajbi
  • , Clarisse Eveno
  • , Jean Michel Fabre
  • , Joseph Fabre
  • , Johan Gagniere
  • , Marie Pierre Galais
  • , Adeline Germain
  • , Sophie Geyl
  • , Olivier Glehen
  • , Diane Goere
  • , Jean Marc Gornet
  • , Victoire Granger
  • , Caroline Gronnier
  • , Rosine Guimbaud
  • , Vincent Hautefeuille
  • , Morgane Helyon
  • , Jacques Jougon
  • , Gilles Lebreton
  • , Jérémie H Lefevre
  • , Côme Lepage
  • , Astrid Lievre
  • , Frédéric Marchal
  • , Pierre Mathieu
  • , Muriel Mathonnet
  • , Tamara Mathysiak
  • , Bernard Meunier
  • , Nicolas Michot
  • , David Moszkowicz
  • , Driffa Moussata
  • , Simon Msika
  • , Cindy Neuzillet
  • , Medhi Ouaissi
  • , Brice Paquette
  • , François Paye
  • , Christophe Penna
  • , Guillaume Père
  • , Marine Perrier
  • , Frédérique Peschaud
  • , Denis Pezet
  • , Valérie Phoutthsang
  • , Guillaume Piessen
  • , Marc Pocard
  • , Paul Rat
  • , Nicolas Regenet
  • , Jean Marc Regimbeau
  • , Florence Renaud
  • , Jean-Marc Sabate
  • , Régis Souche
  • , Eric Terrebonne
  • , Williams Tessier
  • , Pascal Alexandre Thomas
  • , Anthony Turpin
  • , Delphine Vaudoyer
  • , Angélique Vienot
  • , Thibault Voron
  •  & Benoit You

Contributions

Conception, design, analysis, and interpretation of data: Lucie Gehenne, Sophie Lelorain, Clarisse Eveno, Guillaume Piessen, Christophe Mariette, and Véronique Christophe.

Data acquisition: Lucie Gehenne, Olivier Glehen, Xavier D’journo, Muriel Mathonnet, Nicolas Regenet, Bernard Meunier, and Anne-Sophie Baudry.

Drafting the article and revising: all authors.

Final approval: all authors.

Corresponding authors

Correspondence to Lucie Gehenne or Véronique Christophe.

Ethics declarations

Ethics approval

The study was conducted in accordance with the Declaration of Helsinki, the French regulation on clinical trials, and authorizations from the “Comité de Protection des Personnes Nord Ouest IV” (Ethics Committee, project number: 13/67).

Consent to participate

All participants provided written informed consent.

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N/A

Conflict of interest

The authors declare no competing interests.

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Christophe Mariette is deceased.

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Gehenne, L., Lelorain, S., Eveno, C. et al. Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients. Support Care Cancer 29, 7551–7561 (2021). https://doi.org/10.1007/s00520-021-06257-y

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