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Pretreatment depression as a prognostic indicator of survival and nutritional status in patients with head and neck cancer
Author(s) -
Kim ShinAe,
Roh JongLyel,
Lee SangAh,
Lee Sangwook,
Kim SungBae,
Choi SeungHo,
Nam Soon Yuhl,
Kim Sang Yoon
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29693
Subject(s) - medicine , depression (economics) , head and neck cancer , quality of life (healthcare) , cancer , beck depression inventory , univariate analysis , head and neck squamous cell carcinoma , oncology , multivariate analysis , anxiety , psychiatry , nursing , economics , macroeconomics
BACKGROUND The emotional status of cancer patients is associated with disease course and treatment outcomes. In this study, the authors evaluated associations between the presence of pretreatment depression and pretreatment quality of life (QOL), nutritional status, and survival outcomes in patients with head and neck squamous cell carcinoma (HNSCC). METHODS For this prospective study, 241 patients with previously untreated HNSCC who underwent curative treatments were enrolled. Patients completed the Beck Depression Inventory (BDI)‐II, the European Organization for Research and Treatment of Cancer (EORTC) 30‐item Core QOL Questionnaire (QLQ‐C30), and the EORTC QLQ Head and Neck Cancer module (QLQ‐H&N35). EORTC QLQ scores were compared between depressive and nondepressive patients, as determined according to pretreatment BDI‐II scores ≥14 and <14, respectively. Univariate and multivariate analyses were performed to assess whether the presence of depression was associated with overall survival, disease‐free survival (DFS), or posttreatment changes in nutritional status and laboratory data. RESULTS Pretreatment depression was present in 60 patients (24.9%). In depressive and nondepressive patients, the 3‐year overall survival rates were 70.8% and 82.7%, respectively ( P = .045), and the 3‐year DFS rates were 63.5% and 79.1%, respectively ( P = .015). After controlling for clinical factors, the presence of depression was predictive of 3‐year DFS ( P = .032). EORTC QLQ‐C30 and QLQ‐HN35 scores on all items except feeding tube, nutritional supplement, and problem with mouth opening differed between depressive and nondepressive patients ( P < .05). Depressive patients had lower pretreatment serum albumin levels than nondepressive patients ( P < .05). CONCLUSIONS There was a significant correlation between pretreatment depression and pretreatment QOL, nutritional status, and survival outcomes in patients with HNSCC. Cancer 2016;122:131–140. © 2015 American Cancer Society .