Latent transition analysis of gastrointestinal symptom clusters and their influencing factors in patients with primary gastric cancer before and after chemotherapy

ObjectiveTo analyze the latent transition status of gastrointestinal symptom clusters and their influencing factors in patients with primary gastric cancer before and after chemotherapy.MethodsA total of 219 patients with primary gastric cancer who received postoperative chemotherapy at the department of traditional Chinese medicine of The First Affiliated Hospital of Soochow University were selected as study subjects by a convenience sampling method from January 2024 to June 2025.The severity of gastrointestinal symptoms was assessed using the Chinese version of the MD Anderson Symptom Inventory⁃Gastrointestinal Cancer Module at 1⁃3 days before chemotherapy and 5⁃7 days after chemotherapy.Latent transition analysis was performed to explore the transition probabilities of gastrointestinal symptom classes before and after chemotherapy.Multivariate Logistic regression analysis was used to identify the influencing factors of latent transition in gastrointestinal symptom clusters.ResultsGastrointestinal symptoms before and after chemotherapy in gastric cancer patients were classified into two groups,namely mild symptom group and symptom distress group.From pre-chemotherapy to post-chemotherapy,the probabilities of remaining in the same group were 48.7% for the mild symptom group and 77.5% for the symptom distress group.The probability of transitioning from the mild symptom group to the symptom distress group was 51.3%,while the probability of transitioning from the symptom distress group to the mild symptom group was 22.5%.Age,education level,body mass index,and clinical stage were identified as influencing factors for the latent transition of gastrointestinal symptom clusters before and after chemotherapy in patients with primary gastric cancer(P<0.05).ConclusionsThere was group heterogeneity in gastrointestinal symptoms among patients with primary gastric cancer before and after chemotherapy.Healthcare providers should accurately identify the transition patterns of symptom clusters and their influencing factors,and implement precise symptom management strategies.