Risk as a pattern over time: Delineation of time‐dependent risk factors in biological, psychological, and social variables in cancer patients

Autor(en)

Matthias Knefel, Elisabeth L. Zeilinger, Simone Lubowitzki, Katharina Krammer, Matthias Unseld, Rupert Bartsch, Thorsten Fuereder, Ulrich Jäger, Barbara Kiesewetter, Maria Krauth, Markus Raderer, Philipp B. Staber, Peter Valent, Alexander Gaiger

Abstrakt

Background: Survival in cancer patients is associated with a multitude of biological, social, and psychological factors. Although it is well established that all these factors add to overall mortality, it is not well understood how the predictive power of these parameters changes in a comprehensive model and over time. Methods: Patients who attended the authors’ outpatient clinic were invited to participate. The authors followed 5180 mixed cancer patients (51.1% female; mean age, 59.1 years [SD = 13.8]) for up to 16 years and analyzed biological (age, sex, cancer site, anemia), psychological (anxiety, depression), and social variables (marital status, education, employment status) potentially predicting overall survival in a Cox proportional hazards model. Results: The median survival time for the entire sample was 4.3 years (95% confidence interval, 4.0–4.7). The overall survival probabilities for 1 and 10 years were 76.8% and 38.0%, respectively. Following an empirical approach, the authors split the time interval into five periods: acute, subacute, short-term, medium-term, and long-term. A complex pattern of variables predicted overall survival differently in the five periods. Biological parameters were important throughout most of the time, social parameters were either time-independent predictors or tended to be more important in the longer term. Of the psychological parameters, only depression was a significant predictor and lost its predictive power in the long-term. Conclusions: The findings of this study allow the development of comprehensive patient-specific models of risk and resilience factors addressing biopsychosocial needs of cancer patients, paving the way for a personalized treatment plan that goes beyond biomedical cancer care.

Organisation(en)

Externe Organisation(en)

Medizinische Universität Wien

Journal

Cancer

Band

129

Seiten

3466-3475

Anzahl der Seiten

10

ISSN

0008-543X

DOI

https://doi.org/10.1002/cncr.34953

Publikationsdatum

11-2023

Peer-reviewed

Ja

ÖFOS 2012

501010 Klinische Psychologie, 302055 Onkologie

Schlagwörter

ASJC Scopus Sachgebiete

Oncology, Cancer Research

Sustainable Development Goals

SDG 3 – Gesundheit und Wohlergehen

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/08ed5b37-791f-4384-a727-927ec61d91d5