Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer

Schofield, Penelope E., Stockler, M. R., Zannino, D., Tebbutt, N. C., Price, T. J., Simes, R. J., Wong, N., Pavlakis, N., Ransom, D., Moylan, E., Underhill, C., Wyld, D., Burns, I., Ward, R., Wilcken, N. and Jefford, M. (2016) Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer. Supportive Care in Cancer, 24 1: 401-408. doi:10.1007/s00520-015-2792-8


Author Schofield, Penelope E.
Stockler, M. R.
Zannino, D.
Tebbutt, N. C.
Price, T. J.
Simes, R. J.
Wong, N.
Pavlakis, N.
Ransom, D.
Moylan, E.
Underhill, C.
Wyld, D.
Burns, I.
Ward, R.
Wilcken, N.
Jefford, M.
Title Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer
Journal name Supportive Care in Cancer   Check publisher's open access policy
ISSN 1433-7339
0941-4355
Publication date 2016-01
Year available 2015
Sub-type Article (original research)
DOI 10.1007/s00520-015-2792-8
Open Access Status Not Open Access
Volume 24
Issue 1
Start page 401
End page 408
Total pages 8
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2016
Language eng
Formatted abstract
Purpose
Psychological responses to cancer are widely believed to affect survival. We investigated associations between hope, optimism, anxiety, depression, health utility and survival in patients starting first-line chemotherapy for metastatic colorectal cancer.

Methods
Four hundred twenty-nine subjects with metastatic colorectal cancer in a randomised controlled trial of chemotherapy completed baseline questionnaires assessing the following: hopefulness, optimism, anxiety and depression and health utility. Hazard ratios (HRs) and P values were calculated with Cox models for overall survival (OS) and progression-free survival (PFS) in univariable and multivariable analyses.

Results
Median follow-up was 31 months. Univariable analyses showed that OS was associated negatively with depression (HR 2.04, P < 0.001) and positively with health utility (HR 0.56, P < 0.001) and hopefulness (HR 0.75, P = 0.013). In multivariable analysis, OS was also associated negatively with depression (HR 1.72, P < 0.001) and positively with health utility (HR 0.73, P = 0.014), but not with optimism, anxiety or hopefulness. PFS was not associated with hope, optimism, anxiety or depression in any analyses.

Conclusions
Depression and health utility, but not optimism, hope or anxiety, were associated with survival after controlling for known prognostic factors in patients with advanced colorectal cancer. Further research is required to understand the nature of the relationship between depression and survival. If a causal mechanism is identified, this may lead to interventional possibilities.
Keyword Hope
Optimism
Colorectal cancer
Survival
Health utility
Depression
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 21 June 2015

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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