Psychosocial factors and survival after diagnosis of inoperable non-small cell lung cancer.
OBJECTIVE
Although several previous studies have investigated the association between psychosocial factors and the survival of lung cancer patients, most previous studies were flawed by severe methodological limitations. The purpose of the present study was to use a rigorous study design to investigate the association between relevant psychosocial factors and survival after a diagnosis of inoperable non-small cell lung cancer (NSCLC).


METHODS
The subjects were 122 consecutive newly diagnosed patients with inoperable NSCLC. Patients coping with cancer, psychological distress, clinical depression, and social support were evaluated after diagnosis but before treatment and 2 months later. After a 2-year follow-up period, 108 patients had died. The survival data were censored for the remaining 14 patients. The influence of psychosocial factors after diagnosis but before treatment on survival time was analyzed using a Cox regression, with adjustments for well-established (definite and/or possible) prognostic factors. The stability of the investigated psychosocial factors was also examined.


RESULTS
None of the examined psychosocial factors significantly predicted survival time among the patients with inoperable NSCLC. Among the biomedical factors that were examined, advanced clinical stage, a high serum lactate dehydrogenase level, and not receiving chemotherapy were independently associated with shorter survival periods. Most of the psychosocial factors exhibited a moderate to high stability.


CONCLUSIONS
We found little convincing evidence that psychosocial factors after cancer diagnosis had a clinically relevant effect on the survival of inoperable patients with NSCLC.
Akechi
Tatsuo
T
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Okamura
Hitoshi
H
Okuyama
Toru
T
Furukawa
Toshiaki A
TA
Nishiwaki
Yutaka
Y
Uchitomi
Yosuke
Y
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001526:Behavioral Symptoms / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012944:Social Support; D012959:Socioeconomic Factors; D015996:Survival Rate