Depression, immunity, and survival in patients with hepatobiliary carcinoma.

Depression, immunity, and survival in patients with hepatobiliary carcinoma. Research Abstract Details 

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Depression, immunity, and survival in patients with hepatobiliary carcinoma. Abstract Text:

James C Coyne,Steven C Palmer,James C Coyne,Steven C Palmer,

PURPOSE: The aims of the present study were to assess the prevalence of depressive symptoms at diagnosis, test the association between depressive symptoms and survival, and preliminarily test a mediational model of depression, immunity, and survival in patients with hepatobiliary carcinoma (HBC). PATIENTS AND METHODS: One hundred one patients diagnosed with HBC were prospectively studied. Depressive symptoms were measured at diagnosis using the Center for Epidemiological Studies Depression Scale (CES-D). Sociodemographic and disease-specific data were gathered from the patients' charts. In a subsample of patients, stress; alcohol, tobacco, and drug use; sleep quality; physical activity; social support; natural killer (NK) cell number and cytotoxicity; and plasma levels of interleukin (IL) -4, IL-5, tumor necrosis factor alpha, and interferon gamma were measured. Survival was measured from date of diagnosis to death. RESULTS: At diagnosis, 37% of patients reported a CES-D score of > or = 16 (clinical range). Using Cox regression analysis, sociodemographic and disease-specific variables and CES-D score significantly predicted survival (Breslow chi2 = 32.4, P = .006). Only vascular invasion (P = .001) and CES-D score > or = 16 (P = .03) were significant predictors. In a subsample of 23 patients, patients who reported a CES-D score of > or = 16 were found to have significantly lower NK cell numbers than patients who reported a CES-D score of less than 16 (F1,21 = 9.39, P = .003). A robust trend was found in which NK cell number was associated with survival. A mediational model linking depressive symptoms and survival, with NK cell number as a mediator, was preliminarily supported. CONCLUSION: Secondary to the high prevalence of depressive symptoms and impact on survival, psychological and pharmacologic interventions should be designed and implemented in patients diagnosed with HBC.

Depression, immunity, and survival in patients with hepatobiliary carcinoma. Publishing Authors By Initials

JC Coyne,SC Palmer,JC Coyne,SC Palmer,

For similar investigative techniques: epidemiologic methods: statistics as topic: survival analysis research abstracts see: investigative techniques: epidemiologic methods: statistics as topic: survival analysis research

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MEDLINE DATE:

Depression, immunity, and survival in patients with hepatobiliary carcinoma. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Journal of clinical oncology : official journal of

VOLUME: 25

Page Numbers: 2397-405

Journal Abbreviation: J. Clin. Oncol.

ISSN: 1527-7755

DAY: 10

MONTH: Jun

YEAR: 2007

Depression, immunity, and survival in patients with hepatobiliary carcinoma. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8309333

Depression, immunity, and survival in patients with hepatobiliary carcinoma. Keywords Mesh Terms:

KEYWORDS: Survival Analysis

MESH TERMS: psychology

Chemical & Substance for Abstract: Depression, immunity, and survival in patients with hepatobiliary carcinoma. Information

Substance Name: Cytokines

Registry Number: 0

Grant and Affiliation Information for Depression, immunity, and survival in patients with hepatobiliary carcinoma.

AFFILIATION: University of Pittsburgh School of Medicine, Liver Cancer Center, Department of Surgery, Starzl Transplantation Institute, Pittsburgh, PA 15213, USA. steeljl@msx.upmc.edu

Country: United States

AGENCY: United States NHLBI

GRANT: HL076858

ACRONYM: HL

MEDLINETA: J Clin Oncol

REFSOURCE: J Clin Oncol. 2007 Nov 20;25(33):5328-9;

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