Depressive symptoms predict head and neck cancer survival: Examining plausible behavioral and biological pathways. Issue 5 (22nd January 2018)

• Record Type: Journal Article
• Authors: Zimmaro, Lauren A.; Sephton, Sandra E.; Siwik, Chelsea J.; Phillips, Kala M.; Rebholz, Whitney N.; Kraemer, Helena C.; Giese‐Davis, Janine; Wilson, Liz; Bumpous, Jeffrey M.; Cash, Elizabeth D.
• Is Part Of: Cancer. Volume 124:Issue 5(2018)
• Page Start: 1053
• Page End: 1060
• Publication Date: 2018-01-22
• Subjects: depression -- head and neck cancer -- residual tumor -- survival; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.31109
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Head and neck cancers are associated with high rates of depression, which may increase the risk for poorer immediate and long‐term outcomes. Here it was hypothesized that greater depressive symptoms would predict earlier mortality, and behavioral (treatment interruption) and biological (treatment response) mediators were examined. METHODS: Patients (n = 134) reported depressive symptomatology at treatment planning. Clinical data were reviewed at the 2‐year follow‐up. RESULTS: Greater depressive symptoms were associated with significantly shorter survival (hazard ratio, 0.868; 95% confidence interval [CI], 0.819‐0.921; P < .001), higher rates of chemoradiation interruption (odds ratio, 0.865; 95% CI, 0.774‐0.966; P = .010), and poorer treatment response (odds ratio, 0.879; 95% CI, 0.803‐0.963; P = .005). The poorer treatment response partially explained the depression‐survival relation. Other known prognostic indicators did not challenge these results. CONCLUSIONS: Depressive symptoms at the time of treatment planning predict overall 2‐year mortality. Effects are partly influenced by the treatment response. Depression screening and intervention may be beneficial. Future studies should examine parallel biological pathways linking depression to cancer survival, including endocrine disruption and inflammation. Cancer 2018;124:1053‐60 . © 2018 American Cancer Society . Abstract : Depressive symptoms at the time of treatment planning predict overall mortality for patients with head and neck cancer at 2 years. A poorer tumor response to treatment (but not other known prognostic indicators) partially explains the depression‐survival relation.