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

Support Care Cancer. 2021 Dec;29(12):7551-7561. doi: 10.1007/s00520-021-06257-y. Epub 2021 Jun 10.


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.

Keywords: Cancer; Empathy; Patient-physician communication; Postoperative complications.

MeSH terms

  • Empathy
  • Esophageal Neoplasms*
  • Humans
  • Perception
  • Physician-Patient Relations
  • Retrospective Studies
  • Stomach Neoplasms* / surgery
  • Surgeons*