Social influences on clinical outcomes of patients with ovarian cancer.
OBJECTIVE
Previous research has demonstrated relationships of social support with disease-related biomarkers in patients with ovarian cancer. However, the clinical relevance of these findings to patient outcomes has not been established. This prospective study examined how social support relates to long-term survival among consecutive patients with ovarian cancer. We focused on two types of social support: social attachment, a type of emotional social support reflecting connections with others, and instrumental social support reflecting the availability of tangible assistance.


METHODS
Patients were prospectively recruited during a presurgical clinic visit and completed surveys before surgery. One hundred sixty-eight patients with histologically confirmed epithelial ovarian cancer were observed from the date of surgery until death or December 2010. Clinical information was obtained from medical records.


RESULTS
In a Cox regression model, adjusting for disease stage, grade, histology, residual disease, and age, greater social attachment was associated with a lower likelihood of death (hazard ratio [HR], 0.87; 95% CI, 0.77 to 0.98; P = .018). The median survival time for patients with low social attachment categorized on a median split of 15 was 3.35 years (95% CI, 2.56 to 4.15 years). In contrast, by study completion, 59% of patients with high social attachment were still alive after 4.70 years. No significant association was found between instrumental social support and survival, even after adjustment for covariates.


CONCLUSIONS
Social attachment is associated with a survival advantage for patients with ovarian cancer. Clinical implications include the importance of screening for deficits in the social environment and consideration of support activities during adjuvant treatment.
Department of Psychology, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242, USA. susan-lutgendorf@uiowa.edu
Susan K
SK
Lutgendorf
Koen
K
De Geest
David
D
Bender
Amina
A
Ahmed
Michael J
MJ
Goodheart
Laila
L
Dahmoush
M Bridget
MB
Zimmerman
Frank J
FJ
Penedo
Joseph A
JA
Lucci
Parvin
P
Ganjei-Azar
Premal H
PH
Thaker
Luis
L
Mendez
David M
DM
Lubaroff
George M
GM
Slavich
Steven W
SW
Cole
Anil K
AK
Sood
D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010051:Ovarian Neoplasms / Q000523:psychology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012944:Social Support