期刊
BREAST CANCER RESEARCH AND TREATMENT
卷 180, 期 1, 页码 121-134出版社
SPRINGER
DOI: 10.1007/s10549-020-05526-4
关键词
Breast cancer; Supportive-expressive group therapy; Resilience; Survival; Instrumental variable; Propensity analysis
类别
资金
- National Natural Science Foundation of China [71904033]
- Humanity and Social Science Youth Foundation of Ministry of Education [19YJCZH227]
- Medical Scientific Research Foundation of Guangdong Province [A2019484]
- Research Fund for Talented Scholars of Guangzhou University of Chinese Medicine [A1-AFD018]
- Innovative Project of Guangzhou University of Chinese Medicine [2016KYTD08]
Purpose Randomized control trials exploring adjuvant supportive-expressive group therapy (SEGT) for breast cancer have yielded conflicting survival results. This retrospective cohort study was designed to explore the association of adjuvant SEGT performed at diagnosis with survival in real-world patients. Methods 3327 patients with breast cancer were divided between those who received oncologic treatment combined with SEGT-based intervention (referred to as BRBC [n = 354]) and those who only received oncologic treatment (referred to as OT [n = 2973]). Primary outcome was overall survival (OS) at 1-year, 3-year, 5-year. Propensity score-matched analysis (at a ratio of 1:3) and instrumental variable analysis (IVA) were performed. Results The median overall survival was 7.3 years (95% CI 7.0-7.7 years) in BRBC and 7.1 years (95% CI 6.9-7.4 years) in OT. BRBC was not significantly associated with improved 1-year (HR 0.74, 95% CI 0.49-1.10, P = 0.1748; NNT = 44.8, 95% CI - 118.5 to 22.6), 3-year (HR 0.98, 95% CI 0.75-1.27, P = 0.8640; NNT = 273.7, 95% CI - 21.0 to 21.3), or 5-year survival (HR 0.79, 95% CI 0.61-1.02, P = 0.0908; NNT = 36.0, 95% CI - 384.5 to 19.1) compared with OT. IVA indicated that BRBC had a survival benefit over OT in the 1-year, 3-year, and 5-year of 1.5% (95% CI 1.2-1.9%), 0.7% (95% CI 0.6-0.8%), and 2.6% (95% CI 2.0-3.4%), respectively. Conclusion Adjuvant SEGT cannot significantly prolong 5-year survival in breast cancer, though a longer observation period is warranted according to the marginal survival benefit identified at the end of the follow-up.
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