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

J Clin Oncol. 2004 Nov 1;22(21):4255-60. doi: 10.1200/JCO.2004.12.129. Epub 2004 Sep 27.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Affect
  • Aged
  • Attitude to Health
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / psychology*
  • Chemotherapy, Adjuvant
  • Cognitive Behavioral Therapy*
  • Existentialism*
  • Female
  • Humans
  • Middle Aged
  • Patient Satisfaction
  • Proportional Hazards Models
  • Psychotherapy, Group*
  • Social Support
  • Survival Analysis
  • Treatment Outcome