No effect on survival of home psychosocial intervention in a randomized study of Danish colorectal cancer patients.
OBJECTIVE
We investigated whether regular home visits to persons with newly diagnosed colorectal cancer influenced their overall survival and selected immune parameters.


METHODS
A total of 249 Danish colorectal cancer patients undergoing abdominal surgery were randomly assigned to a control or an intervention group. The intervention group received 10 home visits from a project nurse or a medical doctor during the first 2 years after discharge. The home visits aimed at providing emotional support and information. A subgroup of 55 patients provided blood samples 3, 12 and 24 months after discharge for measurement of immune parameters. Survival was assessed 6.5-9.5 years after the first operation.


RESULTS
A total of 148 patients died during follow-up. The intervention was not significantly associated with survival (p=0.68) after adjustment for Dukes' stage, radicality of the operation, age, sex, family social class and marital status. Likewise, no significant interactions were found between group and these covariates (all p > or = 0.08). In the substudy of the possible effect of the intervention on immune parameters, there were no differences between the two groups with respect to lymphocyte proliferation (all p > or = 0.078) or natural killer cell activity (all p > or = 0.33) and no consistent effect on the number of specific subsets of cells (phenotypes) during follow-up.


CONCLUSIONS
The study failed to provide evidence that the psychosocial intervention provided as home visits significantly affected the prognosis or selected immune parameters of patients who had undergone surgery for colorectal cancer.
Ross
Lone
L
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. lone.ross@dadlnet.dk
Frederiksen
Kirsten
K
Boesen
Sidsel H
SH
Karlsen
Randi V
RV
Rasmussen
Morten S
MS
Sørensen
Lars T
LT
Jørgensen
Torben
T
Claesson
Mogens H
MH
Johansen
Christoffer
C
D000368:Aged; D015179:Colorectal Neoplasms / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D003152:Community Health Nursing; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006792:House Calls; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010353:Patient Education as Topic; D012944:Social Support; D015996:Survival Rate