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Supportive Care in Cancer
Published in: Supportive Care in Cancer 1/2016

01-01-2016 | Original Article

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

Authors: Penelope E. Schofield, M. R. Stockler, D. Zannino, N. C. Tebbutt, T. J. Price, R. J. Simes, N. Wong, N. Pavlakis, D. Ransom, E. Moylan, C. Underhill, D. Wyld, I. Burns, R. Ward, N. Wilcken, M. Jefford

Published in: Supportive Care in Cancer | Issue 1/2016

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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.
Appendix
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Metadata
Title
Hope, optimism and survival in a randomised trial of chemotherapy for metastatic colorectal cancer
Authors
Penelope E. Schofield
M. R. Stockler
D. Zannino
N. C. Tebbutt
T. J. Price
R. J. Simes
N. Wong
N. Pavlakis
D. Ransom
E. Moylan
C. Underhill
D. Wyld
I. Burns
R. Ward
N. Wilcken
M. Jefford
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 1/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2792-8

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