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- Title
Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer.
- Authors
Shin-Ae Kim; Jong-Lyel Roh; Sang-Ah Lee; Sang-wook Lee; Sung-Bae Kim; Seung-Ho Choi; Soon Yuhl Nam; Sang Yoon Kim; Kim, Shin-Ae; Roh, Jong-Lyel; Lee, Sang-Ah; Lee, Sang-Wook; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon
- Abstract
<bold>Background: </bold>The emotional status of cancer patients is associated with disease course and treatment outcomes. In this study, the authors evaluated associations between the presence of pretreatment depression and pretreatment quality of life (QOL), nutritional status, and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC).<bold>Methods: </bold>For this prospective study, 241 patients with previously untreated HNSCC who underwent curative treatments were enrolled. Patients completed the Beck Depression Inventory (BDI)-II, the European Organization for Research and Treatment of Cancer (EORTC) 30-item Core QOL Questionnaire (QLQ-C30), and the EORTC QLQ Head and Neck Cancer module (QLQ-H&N35). EORTC QLQ scores were compared between depressive and nondepressive patients, as determined according to pretreatment BDI-II scores ≥ 14 and <14, respectively. Univariate and multivariate analyses were performed to assess whether the presence of depression was associated with overall survival, disease-free survival (DFS), or posttreatment changes in nutritional status and laboratory data.<bold>Results: </bold>Pretreatment depression was present in 60 patients (24.9%). In depressive and nondepressive patients, the 3-year overall survival rates were 70.8% and 82.7%, respectively (P = .045), and the 3-year DFS rates were 63.5% and 79.1%, respectively (P = .015). After controlling for clinical factors, the presence of depression was predictive of 3-year DFS (P = .032). EORTC QLQ-C30 and QLQ-HN35 scores on all items except feeding tube, nutritional supplement, and problem with mouth opening differed between depressive and nondepressive patients (P < .05). Depressive patients had lower pretreatment serum albumin levels than nondepressive patients (P < .05).<bold>Conclusions: </bold>There was a significant correlation between pretreatment depression and pretreatment QOL, nutritional status, and survival outcomes in patients with HNSCC.
- Subjects
HEAD &; neck cancer; PATIENT psychology; MENTAL depression; NUTRITION; QUALITY of life; SURVIVAL analysis (Biometry); SERUM albumin; HEAD tumors; LONGITUDINAL method; NECK tumors; PROGNOSIS; PSYCHOLOGICAL tests; QUESTIONNAIRES; NUTRITIONAL status; SQUAMOUS cell carcinoma; PSYCHOLOGY
- Publication
Cancer (0008543X), 2016, Vol 122, Issue 1, p131
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.29693