Exploring early postoperative core symptoms in Chinese patients with primary liver cancer: a cross-sectional and longitudinal network analysis

Background: Patients with primary liver cancer (PLC) experience a range of symptoms in the early postoperative period. Symptoms include cancer-related symptoms and adverse effects of treatment. Exploring the core symptoms and their dynamics in the early post-hepatectomy patients may help provide better symptom management programs.

Objective: The purpose of this study was to identify the core symptoms in early post-hepatectomy patients and to explore the trajectory of their dynamics.

Methods: During the period from March 2021 to September 2022, a total of 281 patients diagnosed with PLC and undergoing radical curative surgery were recruited from the hepatobiliary surgery departments of two hospitals in Eastern China, among whom 249 individuals (88.6%) agreed to participate in the study. A comprehensive symptom assessment was administered to the patients 1-2 days after surgery (T1) and 1-2 days before discharge (T2). Network analysis was used to identify core symptoms in early post-hepatectomy patients based on symptom severity.

Results: The network analysis identified the core symptoms of dry mouth, pain, abdominal distension, the lack of appetite, and nausea at T1. In contrast, at T2, the lack of appetite, pain, shortness of breath, and disturbed sleep were revealed. At the two early time points, while the results of the network structure test showed no statistically significant difference in the overall symptom network structure, there was a significant difference in the results for the core symptoms.

Conclusion: Our study demonstrates the need to identify core symptoms in the early post-hepatectomy to improve symptom management in PLC patients. It is crucial to apply network analysis as an essential component of cancer care.