Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

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• 作者：Michael H. Antoni ; PhD^a ; ^b ; ^c ; ¹ ; Jamie M. Jacobs ; PhD^d ; ¹ ; ^{jjacobs@mgh.harvard.edu} ; Laura C. Bouchard ; MS^a ; Suzanne C. Lechner ; PhD^b ; ^c ; Devika R. Jutagir ; MS^a ; Lisa M. Gudenkauf ; PhD^a ; Bonnie B. Blomberg ; PhD^c ; ^e ; Stefan Glü ; ck ; MD ; PhD^f ; Charles S. Carver ; PhD^a ; ^c
• 关键词：Breast neoplasms ; Survival ; Depressive symptoms ; Recurrence ; Follow-up study
• 刊名：General Hospital Psychiatry
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：44
• 期：Complete
• 页码：16-21
• 全文大小：338 K
• 卷排序：44

文摘

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.MethodsFrom 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks 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.ResultsA total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; 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.ConclusionsScreening 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.