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Effect of Cognitive-Existential Group Therapy on Survival in Early-Stage Breast Cancer

2004; Lippincott Williams & Wilkins; Volume: 22; Issue: 21 Linguagem: Inglês

10.1200/jco.2004.12.129

1527-7755

David W. Kissane, Anthony W. Love, Allison Hatton, Sidney Bloch, Graeme C. Smith, David M. Clarke, Patricia Miach, Jill Ikin, Nadia Ranieri, Raymond Snyder,

Childhood Cancer Survivors' Quality of Life

Purpose Cognitive-existential group therapy (CEGT) was developed to improve mood and mental attitude toward cancer in women with early-stage breast cancer receiving adjuvant chemotherapy. Given the debate about group therapy's association with increased survival in women with metastatic breast cancer, we were curious to check its effect at a much earlier stage in the cancer journey. Patients and Methods We randomly assigned 303 women with early-stage breast cancer who were receiving adjuvant chemotherapy to either 20 sessions of weekly group therapy plus three relaxation classes (n = 154) or to a control condition of three relaxation classes alone (n = 149). The primary outcome was survival. Results CEGT did not extend survival; the median survival time was 81.9 months (95% CI, 64.8 to 99.0 months) in the group-therapy women and 85.5 months (95% CI, 67.5 to 103.6 months) in the control arm. The hazard ratio for death was 1.35 (95% CI, 0.76 to 2.39; P = .31). In contrast, histology and axillary lymph node status were significant predictors of survival. Low-grade histology yielded a hazard ratio of 0.342 (95% CI, 0.17 to 0.69), and axillary lymph node–negative status yielded a hazard ratio of 0.397 (95% CI, 0.20 to 0.78). Conclusion CEGT does not prolong survival in women with early-stage breast cancer.