TY - JOUR
T1 - Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer
T2 - a role for targeted support during initial treatment decision-making?
AU - Price, Melanie A.
AU - Butow, Phyllis N.
AU - Bell, Melanie L.
AU - deFazio, Anna
AU - Friedlander, Michael
AU - Fardell, Joanna E.
AU - Protani, Melinda M.
AU - Webb, Penelope M.
AU - AOCS—Quality of Life Study Investigators on behalf of the Australian Ovarian Cancer Study Group, of Life Study Investigators on behalf of the Australian Ovarian Cancer Study Group
N1 - Funding Information:
This study was funded by The Cancer Councils of New South Wales and Queensland (RG 36/05). Financial support for the parent study was provided by the U.S. Army Medical Research and Materiel Command under DAMD17-01-1-0729; National Health and Medical Research Council (NHMRC) grants 400413, 400281; and Cancer Councils of New South Wales, Queensland, South Australia, Tasmania, Victoria and Western Australia. Additional recruitment was conducted under the Australian Cancer Study (Ovarian Cancer) NHMRC (199600). P Butow is supported by NHMRC Principal Research Fellowship (211199, 457093). P Webb is supported by NHMRC Senior Research Fellowship (1043134).
Publisher Copyright:
© 2016, Springer-Verlag Berlin Heidelberg.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Purpose: Women with advanced ovarian cancer generally have a poor prognosis but there is significant variability in survival despite similar disease characteristics and treatment regimens. The aim of this study was to determine whether psychosocial factors predict survival in women with ovarian cancer, controlling for potential confounders. Methods: The sample comprised 798 women with invasive ovarian cancer recruited into the Australian Ovarian Cancer Study and a subsequent quality of life study. Validated measures of depression, optimism, minimization, helplessness/hopelessness, and social support were completed 3–6 monthly for up to 2 years. Four hundred nineteen women (52.5 %) died over the follow-up period. Associations between time-varying psychosocial variables and survival were tested using adjusted Cox proportional hazard models. Results: There was a significant interaction of psychosocial variables measured prior to first progression and overall survival, with higher optimism (adjusted hazard ratio per 1 standard deviation (HR) = 0.80, 95 % confidence interval (CI) 0.65–0.97), higher minimization (HR = 0.79, CI 0.66–0.94), and lower helplessness/hopelessness (HR = 1.40, CI 1.15–1.71) associated with longer survival. After disease progression, these variables were not associated with survival (optimism HR = 1.10, CI 0.95–1.27; minimization HR = 1.12, CI 0.95–1.31; and helplessness/hopelessness HR = 0.86, CI 0.74–1.00). Depression and social support were not associated with survival. Conclusions: In women with invasive ovarian cancer, psychosocial variables prior to disease progression appear to impact on overall survival, suggesting a preventive rather than modifying role. Addressing psychosocial responses to cancer and their potential impact on treatment decision-making early in the disease trajectory may benefit survival and quality of life.
AB - Purpose: Women with advanced ovarian cancer generally have a poor prognosis but there is significant variability in survival despite similar disease characteristics and treatment regimens. The aim of this study was to determine whether psychosocial factors predict survival in women with ovarian cancer, controlling for potential confounders. Methods: The sample comprised 798 women with invasive ovarian cancer recruited into the Australian Ovarian Cancer Study and a subsequent quality of life study. Validated measures of depression, optimism, minimization, helplessness/hopelessness, and social support were completed 3–6 monthly for up to 2 years. Four hundred nineteen women (52.5 %) died over the follow-up period. Associations between time-varying psychosocial variables and survival were tested using adjusted Cox proportional hazard models. Results: There was a significant interaction of psychosocial variables measured prior to first progression and overall survival, with higher optimism (adjusted hazard ratio per 1 standard deviation (HR) = 0.80, 95 % confidence interval (CI) 0.65–0.97), higher minimization (HR = 0.79, CI 0.66–0.94), and lower helplessness/hopelessness (HR = 1.40, CI 1.15–1.71) associated with longer survival. After disease progression, these variables were not associated with survival (optimism HR = 1.10, CI 0.95–1.27; minimization HR = 1.12, CI 0.95–1.31; and helplessness/hopelessness HR = 0.86, CI 0.74–1.00). Depression and social support were not associated with survival. Conclusions: In women with invasive ovarian cancer, psychosocial variables prior to disease progression appear to impact on overall survival, suggesting a preventive rather than modifying role. Addressing psychosocial responses to cancer and their potential impact on treatment decision-making early in the disease trajectory may benefit survival and quality of life.
KW - Oncology
KW - Ovarian cancer
KW - Predictors
KW - Psychological factors
KW - Survival
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U2 - 10.1007/s00520-015-3070-5
DO - 10.1007/s00520-015-3070-5
M3 - Article
C2 - 26732767
AN - SCOPUS:84953339807
SN - 0941-4355
VL - 24
SP - 2627
EP - 2634
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 6
ER -