Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer
Elizabeth Cash1,2, Christy Albert1, Iona Palmer3
1Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky.
JAMA Otolaryngology-- Head & Neck Surgery
|March 28, 2024
Summary
Depression in head and neck cancer patients is linked to inflammation, which impacts survival. Addressing depression may improve treatment response and outcomes.
Area of Science:
- Oncology
- Psychiatry
- Immunology
Background:
- Head and neck cancer patients have high depression rates.
- Depression and inflammation are linked in cancer, potentially affecting survival.
- Inflammation may mediate depression's impact on head and neck cancer outcomes.
Purpose of the Study:
- To investigate mediation pathways of pretreatment depressive symptoms, inflammation, and tumor response on overall survival in head and neck cancer patients.
- To assess how depression and inflammation influence survival outcomes.
Main Methods:
- Prospective observational cohort study.
- Included 394 head and neck cancer patients.
- Assessed depressive symptoms (PHQ-9), systemic inflammation (SII), tumor response, and 2-year overall survival.
Main Results:
- Depressive symptoms were associated with higher inflammation (partial r = 0.168).
- Both depression (HR = 1.04) and inflammation (HR = 1.36) predicted mortality.
- Inflammation fully mediated the depression-survival link; tumor response partially mediated it.
Conclusions:
- Systemic inflammation is a key mechanism linking depression to mortality in head and neck cancer.
- Addressing depression, even mild symptoms, is crucial for improving treatment response and survival.
- Depression is a feasible target for clinical intervention in head and neck cancer care.
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