Dr Jennifer Steel and colleagues from Pittsburgh,
USA assessed the prevalence of depressive symptoms at diagnosis of hepatobiliary carcinoma.
The research team tested the association between depressive symptoms and survival.
In addition, the team conducted a preliminarily test using a mediational model of depression, immunity, and survival in these patients.
|Vascular invasion predicted survival|
|Journal of Clinical Oncology|
The team prospectively studied 101 patients with hepatobiliary carcinoma.
Depressive symptoms were measured at diagnosis using the Center for Epidemiological Studies Depression Scale.
Sociodemographic and disease-specific data were gathered from the patients' charts.
The team measured several factors in a subsample of patients that included stress, alcohol, tobacco, and drug use .
Sleep quality, physical activity, social support, natural killer cell number and cytotoxicity were also assessed.
The team then measured plasma levels of interleukin -4, interleukin-5, tumor necrosis factor alpha, and interferon gamma.
Survival was measured from date of diagnosis to death.
The researchers found that at diagnosis, 37% of patients reported a Center for Epidemiological Studies Depression Scale score of 16.
The team found that sociodemographic and disease-specific variables significantly predicted survival.
Center for Epidemiological Studies Depression Scale score significantly predicted survival.
The team observed that, after adjustment, only vascular invasion, and Center for Epidemiological Studies Depression Scale score 16 were significant predictors.
In a subsample of 23 patients, patients reporting a Center for Epidemiological Studies Depression Scale score of 16 were found to have lower natural killer cell numbers.
Their levels of natural killer cells were less than patients who reported a Center for Epidemiological Studies Depression Scale score of less than 16.
The research team found a robust trend, in which natural killer cell number was associated with survival.
A mediational model linking depressive symptoms and survival, with natural killer cell number as a mediator, was preliminarily supported.
Dr Steel's team concluded, "Secondary to the high prevalence of depressive symptoms and impact on survival, psychological and pharmacologic interventions should be designed and implemented in patients diagnosed with hepatobiliary carcinoma."