TY - JOUR

T1 - Effects on long-term survival of psychosocial group intervention in early-stage breast cancer

T2 - follow-up of a randomized controlled trial

AU - Kirkegaard, Anne Marie

AU - Dalton, Susanne Oksbjerg

AU - Boesen, Ellen Helle

AU - Karlsen, Randi V.

AU - Flyger, Henrik

AU - Johansen, Christoffer

AU - von Heymann, Annika

N1 - Funding Information: This work was supported by the Psychosocial Research Committee, the Danish Cancer Society [9722559, PP01016, and R192-A11590], the IMK Foundation [5322569], and the University of Southern Denmark. The authors thank Jorne Biccler for statistical assistance. Publisher Copyright: © 2023 Acta Oncologica Foundation.

PY - 2023

Y1 - 2023

N2 - Background: The promise of prolonged survival after psychosocial interventions has long been studied, but not convincingly demonstrated. This study aims to investigate whether a psychosocial group intervention improved long-term survival in women with early-stage breast cancer and investigate differences in baseline characteristics and survival between study participants and non-participants. Methods: A total of 201 patients were randomized to two six-hour psychoeducation sessions and eight weekly sessions of group psychotherapy or care as usual. Additionally, 151 eligible patients declined to participate. Eligible patients were diagnosed and treated at Herlev Hospital, Denmark, and followed for vital status up to 18 years after their primary surgical treatment. Cox’s proportional hazard regressions were used to estimate hazard ratios (HRs) for survival. Results: The intervention did not significantly improve survival in the intervention group compared with the control group (HR, 0.68; 95% confidence interval (CI), 0.41–1.14). Participants and non-participants differed significantly in age, cancer stage, adjuvant chemotherapy, and crude survival. When adjusted, no significant survival difference between participants and non-participants remained (HR, 0.77; 95% CI, 0.53–1.11). Conclusions: We could not show improved long-term survival after the psychosocial intervention. Participants survived longer than nonparticipants, but clinical and demographic characteristics, rather than study participation, seem accountable for this difference.

AB - Background: The promise of prolonged survival after psychosocial interventions has long been studied, but not convincingly demonstrated. This study aims to investigate whether a psychosocial group intervention improved long-term survival in women with early-stage breast cancer and investigate differences in baseline characteristics and survival between study participants and non-participants. Methods: A total of 201 patients were randomized to two six-hour psychoeducation sessions and eight weekly sessions of group psychotherapy or care as usual. Additionally, 151 eligible patients declined to participate. Eligible patients were diagnosed and treated at Herlev Hospital, Denmark, and followed for vital status up to 18 years after their primary surgical treatment. Cox’s proportional hazard regressions were used to estimate hazard ratios (HRs) for survival. Results: The intervention did not significantly improve survival in the intervention group compared with the control group (HR, 0.68; 95% confidence interval (CI), 0.41–1.14). Participants and non-participants differed significantly in age, cancer stage, adjuvant chemotherapy, and crude survival. When adjusted, no significant survival difference between participants and non-participants remained (HR, 0.77; 95% CI, 0.53–1.11). Conclusions: We could not show improved long-term survival after the psychosocial intervention. Participants survived longer than nonparticipants, but clinical and demographic characteristics, rather than study participation, seem accountable for this difference.

KW - Breast cancer

KW - psychoeducational intervention

KW - psychosocial intervention

KW - psychotherapeutic intervention

KW - randomized study

KW - study participation

KW - survival

U2 - 10.1080/0284186X.2023.2203329

DO - 10.1080/0284186X.2023.2203329

M3 - Journal article

C2 - 37102368

AN - SCOPUS:85158162620

VL - 62

SP - 422

EP - 428

JO - Acta Oncologica

JF - Acta Oncologica

SN - 1100-1704

IS - 4

ER -