Michael H Antoni1,2,3, Jamie M Jacobs4, Laura C Bouchard1, Suzanne C Lechner2,3, Devika R Jutagir1, Lisa M Gudenkauf1, Bonnie B Blomberg3,5, Stefan Glück6, Charles S Carver1,3. 1. Department of Psychology, University of Miami, Coral Gables, Florida. 2. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida. 3. Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, Florida. 4. Massachusetts General Hospital Cancer Center, Center for Psychiatric Oncology and Behavioral Sciences and Cancer Outcomes Research Program, Boston, Massachusetts. 5. Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida. 6. Celgene Corporation.
Abstract
BACKGROUND: Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. METHODS: From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2-10weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8-15-year follow-up. RESULTS: A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M=13.56years; SE=0.26) than those in the mild/moderate depressed group (M=11.45years; SE=0.40), Log-rank χ2(1)=4.41, p=0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio=2.56, [95% CI, 1.11 to 5.91], p=0.027. Similar results were observed in a subsample with invasive disease (n=191). Depression category did not predict disease-free survival in the overall or invasive sample. CONCLUSIONS: Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.
BACKGROUND: Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. METHODS: From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2-10weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8-15-year follow-up. RESULTS: A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressedwomen had longer overall survival (M=13.56years; SE=0.26) than those in the mild/moderate depressed group (M=11.45years; SE=0.40), Log-rank χ2(1)=4.41, p=0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio=2.56, [95% CI, 1.11 to 5.91], p=0.027. Similar results were observed in a subsample with invasive disease (n=191). Depression category did not predict disease-free survival in the overall or invasive sample. CONCLUSIONS: Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.
Authors: Michael H Antoni; Sarah R Wimberly; Suzanne C Lechner; Aisha Kazi; Tammy Sifre; Kenya R Urcuyo; Kristin Phillips; Roselyn G Smith; Vida M Petronis; Sophie Guellati; Kurrie A Wells; Bonnie Blomberg; Charles S Carver Journal: Am J Psychiatry Date: 2006-10 Impact factor: 18.112
Authors: Sandra E Sephton; Firdaus S Dhabhar; Alex S Keuroghlian; Janine Giese-Davis; Bruce S McEwen; Alexei C Ionan; David Spiegel Journal: Brain Behav Immun Date: 2009-07-28 Impact factor: 7.217
Authors: Lorenzo Cohen; Steven W Cole; Anil K Sood; Sarah Prinsloo; Clemens Kirschbaum; Jesusa M G Arevalo; Nicholas B Jennings; Shellie Scott; Luis Vence; Qi Wei; Diane Kentor; Laszlo Radvanyi; Nizar Tannir; Eric Jonasch; Pheroze Tamboli; Louis Pisters Journal: PLoS One Date: 2012-08-01 Impact factor: 3.240
Authors: Laura C Bouchard; Hannah M Fisher; Charles S Carver; Youngmee Kim; Michael H Antoni Journal: Psychooncology Date: 2018-12-11 Impact factor: 3.894
Authors: Susan K Lutgendorf; Premal H Thaker; Jesusa M Arevalo; Michael J Goodheart; George M Slavich; Anil K Sood; Steve W Cole Journal: Cancer Date: 2017-11-07 Impact factor: 6.860
Authors: Molly E Ream; Mollie S Pester; Zachary T Goodman; Sierra A Bainter; Michael H Antoni Journal: Psychooncology Date: 2020-12-21 Impact factor: 3.894