Longitudinal changes in depression symptoms and survival among patients with lung cancer

A national cohort assessment

Donald Sullivan, Christopher W. Forsberg, Linda Ganzini, David H. Au, Michael K. Gould, Dawn Provenzale, Christopher G. Slatore

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose Depression symptoms are common among patients with lung cancer patients; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptomswere associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95%CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increasedmortality among participants with early-stage disease (HR, 1.71; 95%CI, 1.27 to 2.31) and those with late-stage disease (HR, 1.32; 95% CI, 1.04 to 1.69). Conclusion Among patients with lung cancer, longitudinal changes in depression symptoms are associated with differences in mortality, particularly among patients with early-stage disease. Symptom remission is associated with a similar mortality rate as never having had depression.

Original languageEnglish (US)
Pages (from-to)3984-3991
Number of pages8
JournalJournal of Clinical Oncology
Volume34
Issue number33
DOIs
StatePublished - Nov 20 2016

Fingerprint

Lung Neoplasms
Survival
Mortality
Observational Studies
Epidemiologic Studies
Outcome Assessment (Health Care)
Prospective Studies
Neoplasms
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Longitudinal changes in depression symptoms and survival among patients with lung cancer : A national cohort assessment. / Sullivan, Donald; Forsberg, Christopher W.; Ganzini, Linda; Au, David H.; Gould, Michael K.; Provenzale, Dawn; Slatore, Christopher G.

In: Journal of Clinical Oncology, Vol. 34, No. 33, 20.11.2016, p. 3984-3991.

Research output: Contribution to journalArticle

Sullivan, Donald ; Forsberg, Christopher W. ; Ganzini, Linda ; Au, David H. ; Gould, Michael K. ; Provenzale, Dawn ; Slatore, Christopher G. / Longitudinal changes in depression symptoms and survival among patients with lung cancer : A national cohort assessment. In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 33. pp. 3984-3991.
@article{29f780088b88472a8e44c20219864c8a,
title = "Longitudinal changes in depression symptoms and survival among patients with lung cancer: A national cohort assessment",
abstract = "Purpose Depression symptoms are common among patients with lung cancer patients; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38{\%}) had depression symptoms at baseline and an additional 105 (14{\%}) developed new-onset depression symptoms during treatment. At baseline, depression symptomswere associated with increased mortality (hazard ratio [HR], 1.17; 95{\%} CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95{\%} CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95{\%} CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95{\%}CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95{\%} CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95{\%} CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increasedmortality among participants with early-stage disease (HR, 1.71; 95{\%}CI, 1.27 to 2.31) and those with late-stage disease (HR, 1.32; 95{\%} CI, 1.04 to 1.69). Conclusion Among patients with lung cancer, longitudinal changes in depression symptoms are associated with differences in mortality, particularly among patients with early-stage disease. Symptom remission is associated with a similar mortality rate as never having had depression.",
author = "Donald Sullivan and Forsberg, {Christopher W.} and Linda Ganzini and Au, {David H.} and Gould, {Michael K.} and Dawn Provenzale and Slatore, {Christopher G.}",
year = "2016",
month = "11",
day = "20",
doi = "10.1200/JCO.2016.66.8459",
language = "English (US)",
volume = "34",
pages = "3984--3991",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "33",

}

TY - JOUR

T1 - Longitudinal changes in depression symptoms and survival among patients with lung cancer

T2 - A national cohort assessment

AU - Sullivan, Donald

AU - Forsberg, Christopher W.

AU - Ganzini, Linda

AU - Au, David H.

AU - Gould, Michael K.

AU - Provenzale, Dawn

AU - Slatore, Christopher G.

PY - 2016/11/20

Y1 - 2016/11/20

N2 - Purpose Depression symptoms are common among patients with lung cancer patients; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptomswere associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95%CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increasedmortality among participants with early-stage disease (HR, 1.71; 95%CI, 1.27 to 2.31) and those with late-stage disease (HR, 1.32; 95% CI, 1.04 to 1.69). Conclusion Among patients with lung cancer, longitudinal changes in depression symptoms are associated with differences in mortality, particularly among patients with early-stage disease. Symptom remission is associated with a similar mortality rate as never having had depression.

AB - Purpose Depression symptoms are common among patients with lung cancer patients; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptomswere associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95%CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increasedmortality among participants with early-stage disease (HR, 1.71; 95%CI, 1.27 to 2.31) and those with late-stage disease (HR, 1.32; 95% CI, 1.04 to 1.69). Conclusion Among patients with lung cancer, longitudinal changes in depression symptoms are associated with differences in mortality, particularly among patients with early-stage disease. Symptom remission is associated with a similar mortality rate as never having had depression.

UR - http://www.scopus.com/inward/record.url?scp=84995783984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995783984&partnerID=8YFLogxK

U2 - 10.1200/JCO.2016.66.8459

DO - 10.1200/JCO.2016.66.8459

M3 - Article

VL - 34

SP - 3984

EP - 3991

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 33

ER -