Objective:We investigated the effect of stoma status (permanent stoma, temporary stoma, or non-stoma) on psychological distress and quality of life (QOL) in Chinese patients with colorectal cancer (CRC) in the early postoperative stage. We also investigated whether body image mediated the association between stoma status and psychological distress and QOL. Methods: A convenience sample of 282 CRC patients 1 to 2 weeks postsurgery participated in an observational, cross-sectional study. Participants completed the following self-report measures: Body Image Scale, Distress Thermometer, Hospital Anxiety and Depression Scale, and Core Quality of Life Questionnaire. Results: The temporary stoma group (TS) and the permanent stoma group (PS) reported worse body image and higher levels of anxiety and depression than the non-stoma group (P < .05). PS reported worse body image than TS (P < .01). Depression and significant body image problems were more prevalent in PS than in TS (P < .05). Stoma status was the strongest factor associated with body image, distress, and depression (P < .05). CRC patients who were younger or in later clinical stages had poorer body image. Body image fully mediated the effect of stoma status on anxiety, depression, and global QOL in PS and TS, but mediated the effect on distress only in PS. Conclusions: Body image problems are common in stoma patients in the early postoperative stage and require early assessment. This study helps to elucidate the role of body image as a mediator. Longitudinal studies are needed to further explore body image distress trajectories. K E Y W O R D S anxiety, body image, cancer, China, colorectal, depression, distress, oncology, quality of life

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Somatostatin receptors are overexpressed in neuroendocrine tumors, whose endogenous ligands are somatostatin. DOTA-TATE is an analogue of somatostatin, which shows high binding affinity to somatostatin receptors. We aim to evaluate the Ga/Lu-labeling DOTA-TATE kit in neuroendocrine tumor model for molecular imaging and to try human-positron emission tomography/computed tomography imaging of Ga-DOTA-TATE in neuroendocrine tumor patients. DOTA-TATE kits were formulated and radiolabeled withGa/Lu for Ga/Lu-DOTA-TATE (M-DOTA-TATE). In vitro and in vivo stability of Lu-DOTA-TATE were performed. Nude mice bearing human tumors were injected withGa-DOTA-TATE or Lu-DOTA-TATE for micro-positron emission tomography and micro-single-photon emission computed tomography/computed tomography imaging separately, and clinical positron emission tomography/computed tomography images ofGa-DOTA-TATE were obtained at 1 h post-intravenous injection from patients with neuroendocrine tumors. Micro-positron emission tomography and micro-single-photon emission computed tomography/computed tomography imaging of Ga-DOTA-TATE andLu-DOTA-TATE both showed clear tumor uptake which could be blocked by excess DOTA-TATE. In addition, Ga-DOTA-TATE-positron emission tomography/computed tomography imaging in neuroendocrine tumor patients could show primary and metastatic lesions.Ga-DOTA-TATE and Lu-DOTA-TATE could accumulate in tumors in animal models, paving the way for better clinical peptide receptor radionuclide therapy for neuroendocrine tumor patients in Asian population.

IntroductionAn electronic Patient-Reported Outcome (ePRO) platform is needed for implementing evidence-based symptom management in outpatients with advanced cancer. We describe the overall protocol and the methodology for measuring symptom burden, to provide critical parameters needed to implement symptom management on the ePRO platform.Methods and analysisThe study focusses on patients with advanced lung cancer, stomach cancer, oesophagus cancer, liver cancer, colorectal cancer or breast cancer. The primary outcome is the change of symptom burden. MD Anderson Symptom Inventory, and other PRO instruments (Insomnia Severity Index, Hospital Anxiety and Depression Scale, 9-item Patient Health Questionnaire and EuroQol-5 dimensions-5 levels version) were used. The secondary outcomes include feasibility of using ePRO, symptom-related quality of life, reasons for no improvement of symptoms, defining frequency of PRO assessments and cut-points, items for screening and management of comorbidity and satisfaction with ePRO platform in patients and health providers. After initial outpatient visit for baseline assessment, ePRO system will automatically send follow-up notification seven times over 4 weeks to patients. The characteristics and changing trajectory of symptoms of patients will be described. Parameters for using PROs, such as optimal time points for follow-up and cut-off point for alert will be determined. The feasibility of ePRO platform to track the changes of target symptoms in outpatients will be evaluated.Ethics and disseminationThe study protocol and related documents were approved by the Institutional Research Board (IRB) of Peking University Cancer Hospital on 13 February 2019 (2019YJZ07). The results of this study will be disseminated through academic workshops, peer-reviewed publications and conferences.Trial registration numberChiCTR1900023560.