Effect of cognitive-existential group therapy on survival in early-stage breast cancer Journal Article


Authors: Kissane, D. W.; Love, A.; Hatton, A.; Bloch, S.; Smith, G.; Clarke, D. M.; Miach, P.; Ikin, J.; Ranieri, N.; Snyder, R. D.
Article Title: Effect of cognitive-existential group therapy on survival in early-stage breast cancer
Abstract: 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. © 2004 by American Society of Clinical Oncology.
Keywords: survival; adult; cancer survival; controlled study; treatment outcome; aged; middle aged; survival analysis; patient satisfaction; major clinical study; clinical trial; cancer adjuvant therapy; chemotherapy, adjuvant; antineoplastic agent; controlled clinical trial; breast cancer; randomized controlled trial; proportional hazards models; attitude to health; breast neoplasms; histology; cancer mortality; axillary lymph node; adaptive behavior; psychological aspect; social support; adaptation, psychological; affect; proportional hazards model; adjuvant chemotherapy; breast tumor; cognitive therapy; relaxation training; existentialism; psychotherapy, group; group therapy; hazard assessment; humans; human; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 22
Issue: 21
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2004-11-01
Start Page: 4255
End Page: 4260
Language: English
DOI: 10.1200/jco.2004.12.129
PROVIDER: scopus
PUBMED: 15452189
DOI/URL:
Notes: J. Clin. Oncol. -- Cited By (since 1996):62 -- Export Date: 16 June 2014 -- CODEN: JCOND -- Source: Scopus
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  1. David W Kissane
    160 Kissane