Symptom clusters and core symptoms in patients with colorectal cancer after postoperative chemotherapy: A cross-sectional network analysis in a predominantly stage II to III cohort

This study aims to investigate symptom characteristics in postoperative chemotherapy patients with colorectal cancer (CRC) and identify their symptom clusters and core symptoms to provide a basis for developing precise symptom management strategies. Convenience sampling was used to select 302 patients with postoperative chemotherapy for CRC as the research object. The general data questionnaire and the Chinese version of the MD Anderson Symptom Inventory-Gastrointestinal Cancer were used for investigation. Exploratory factor analysis was conducted to extract symptom clusters, followed by constructing a symptom network model using R software. Core symptoms were identified by calculating centrality indicators. Exploratory factor analysis identified 5 symptom clusters with a cumulative variance contribution rate of 64.53%, including chemotherapy-related symptoms, psychological symptoms, neurotoxicity-related symptoms, gastrointestinal symptoms, and CRC-specific symptoms. Analysis of symptom prevalence revealed poor appetite (85.4%) as the most common symptom. Network analysis showed that distress (rs = 1.04, re = 1.04) exhibited the highest node strength and expected influence, while fatigue (rc = 0.0047) demonstrated the strongest centrality, confirming it as a core symptom. Distress and fatigue are core symptoms in the symptom network of postoperative chemotherapy patients with CRC. Clinical interventions should focus on these core targets to alleviate overall symptom burden by blocking interactions between symptoms.