JCO Oncol Pract. 2025 Jan 14:OP2400514. doi: 10.1200/OP-24-00514. Online ahead of print.
ABSTRACT
PURPOSE: Early interdisciplinary supportive care (ESC), including psychological interventions, can improve the survival of patients with metastatic esophagogastric cancer (EGC). The purpose of the study was to evaluate the association between psychological factors and survival in patients with metastatic EGC.
METHODS: A secondary analysis was conducted for an open-label randomized controlled trial of ESC, in which 246 patients with EGC completed a distress measure (the distress thermometer) and a depression symptom measure (the Patient Health Questionnaire-9 [PHQ-9]) at baseline before cancer treatments. Cox regression was applied to explore the influence of psychological distress and depressive symptoms on overall survival (OS) and progression-free survival (PFS).
RESULTS: Patients with moderate depressive symptoms (PHQ-9 ≥8) had shorter PFS (3.5 v 6.0 months, P < .001) and shorter OS (10.7 v 15.0 months, P = .001) than those without. Patients with significant psychological distress had worse PFS (4.8 v 6.3 months, P = .035) and worse OS (13.4 v 15.5 months, P = .039) than those without. After controlling for performance status, group, sex, primary tumor site, tumor histology, and age, only depressive symptoms remained associated with worse PFS (adjusted hazard ratio [HR], 2.02 [95% CI, 1.41 to 2.91]; P < .001) and worse OS (adjusted HR, 1.70 [95% CI, 1.17 to 2.47]; P = .006).
CONCLUSION: This study shows that depressive symptoms at baseline were associated with poor survival in patients with newly diagnosed metastatic EGC. Therefore, screening and preventive intervention for depression should be integrated into routine cancer care for this population.
PMID:39808755 | DOI:10.1200/OP-24-00514
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