Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients
Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients
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DOI：
10.1007/s10549-006-9447-x
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发表时间：
2007-10-01
影响因子：
3.8
通讯作者：
Mouridsen, Henning T.
中科院分区：
文献类型：
--
作者：
Groenvold, Mogens;Petersen, Morten Aagaard;Mouridsen, Henning T.
本研究旨在探讨新诊断的乳腺癌患者的心理困扰是否与其生存有关。我们分析了1，588名乳腺癌患者的数据，这些患者在初次手术后2个月填写了EORTC QLQ-C30问卷和医院焦虑和抑郁量表（HADS）。中位随访时间为12.9年。心理困扰（EORTC QLQ-C30情绪功能; HADS焦虑; HADS抑郁）和EORTC疲劳、身体功能和总体评分用于预测无复发和总生存期，使用考克斯多变量回归分析控制已知的临床和组织病理学预后因素（生物学模型）。控制生物学因素后，低水平的心理困扰（良好的EORTC情绪功能）和低疲劳独立预测较长的无复发和总生存期。缺乏焦虑（HADS）也预测了更长的无复发生存期。当与生物学模型结合使用时，疲劳仍然是无复发生存率的重要预测因素（P = 0.0004;风险比1.32（1.13-1.54）），情绪功能仍然是总生存率的重要预测因素（P = 0.0074;风险比0.81（0.70-0.95））。低心理压力和低水平的疲劳可能会导致更大的癌症抵抗力，或者可能反映潜在的精神和身体健壮性。
This study examined whether psychological distress in newly diagnosed breast cancer patients was associated with their survival. We analyzed data from 1,588 breast cancer patients who filled in the EORTC QLQ-C30 questionnaire and the Hospital Anxiety and Depression Scale (HADS) 2 months after their primary operation. The median follow-up time was 12.9 years. Psychological distress (EORTC QLQ-C30 emotional function; HADS anxiety; HADS depression) and EORTC fatigue, physical function, and overall ratings were used to predict recurrence-free and overall survival, controlling for the known clinical and histopathological prognostic factors (biological model) using Cox multivariate regression analysis. Low levels of psychological distress (good EORTC emotional function) and low fatigue independently predicted longer recurrence-free and overall survival, controlling for biological factors. Lack of anxiety (HADS) also predicted longer recurrence-free survival. When added in combination to the biological model, fatigue remained a significant predictor of recurrence-free survival (P = 0.0004; risk ratio 1.32 (1.13-1.54)) and emotional function remained a significant predictor of overall survival (P = 0.0074; risk ratio 0.81 (0.70-0.95)). Low psychological distress and a low level of fatigue may cause a greater cancer resistance or may reflect underlying mental and physical robustness.