title: Does self-regulation and autonomic regulation have an influence on survival in breast and colon carcinoma patients? results of a prospective outcome study.
abstract: BACKGROUND
  Cancer Related Fatigue (CRF) and circadian rhythm have a great impact on the quality of life (HRQL) of patients with breast (BC) and colon cancer (CRC). Other patient related outcomes in oncology are measured by new instruments focusing on adaptive characteristics such as sense of coherence or self-regulation, which could be more appropriate as a prognostic tool than classical HRQL. The aim of this study was to assess the association of autonomic regulation (aR) and self-regulation (SR) with survival.
  
  
  METHODS
  146 cancer patients and 120 healthy controls took part in an initial evaluation in 2000/2001. At a median follow up of 5.9 years later, 62 of 95 BC, 17 of 51 CRC patients, and 85 of 117 healthy controls took part in the follow-up study. 41 participants had died. For the follow-up evaluation, participants were requested to complete the standardized aR and SR questionnaires.
  
  
  RESULTS
  On average, cancer patients had survived for 10.1 years with the disease. Using a Cox proportional hazard regression with stepwise variables such as age, diagnosis group, Charlson co-morbidity index, body mass index (BMI)) aR and SR. SR were identified as independent parameters with potential prognostic relevance on survival While aR did not significantly influence survival, SR showed a positive and independent impact on survival (OR = 0.589; 95%-CI: 0.354 - 0.979). This positive effect persisted significantly in the sensitivity analysis of the subgroup of tumour patients and in the subscale 'Achieve satisfaction and well-being' and by tendency in the UICC stages nested for the different diagnoses groups.
  
  
  CONCLUSIONS
  Self-regulation might be an independent prognostic factor for the survival of breast and colon carcinoma patients and merits further prospective studies.
authors.affiliation: Center of Integrative Medicine, Professorship Quality of Life, Spirituality and Coping, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kröz
authors.forename: Marcus
authors.initials: M
authors.lastname: Reif
authors.forename: Arndt
authors.initials: A
authors.lastname: Büssing
authors.forename: Roland
authors.initials: R
authors.lastname: Zerm
authors.forename: Gene
authors.initials: G
authors.lastname: Feder
authors.forename: Angelina
authors.initials: A
authors.lastname: Bockelbrink
authors.forename: Hans Broder
authors.initials: HB
authors.lastname: von Laue
authors.forename: Harald
authors.initials: H
authors.lastname: Matthes H
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Willich
authors.forename: Matthias
authors.initials: M
authors.lastname: Girke
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology; D001342:Autonomic Nervous System Diseases / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate