Emotional well-being does not predict survival in head and neck cancer patients: a Radiation Therapy Oncology Group study

Cancer. 2007 Dec 1;110(11):2568-75. doi: 10.1002/cncr.23080.


Background: The objective of the current study was to examine whether emotional well-being predicted survival in a large sample of patients with head and neck cancer who were participating in multicenter clinical trials.

Methods: Participants were enrolled in 2 Radiation Oncology Group (RTOG) clinical trials (RTOG 9003 and RTOG 9111) and completed a baseline measure of quality of life (the Functional Assessment of Cancer Therapy-General [FACT-G]), which included an Emotional Well-Being subscale. The outcome measure was overall survival. Main statistical analyses included overall survival rates, which were estimated by using the Kaplan-Meier method with univariate comparisons analyzed using the log-rank test. A multivariate Cox proportional hazards model was used to determine whether emotional well-being had prognostic impact on survival after accounting for tumor-related and sociodemographic variables. Additional exploratory analyses examined possible subgroup effects.

Results: No statistically significant univariate or multivariate effects were observed for emotional well-being, and there were no effects limited to subgroups. These results stand in sharp contrast to the prognostic value of a variety of demographic and clinical variables.

Conclusions: The current results add to the weight of the evidence that emotional functioning is not an independent predictor of survival in cancer patients. The study had the advantage of a large number of deaths to be explained in a sample with the uniformity of treatment and quality of care that is required in clinical trials.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Aged
  • Attitude to Health
  • Disease-Free Survival
  • Emotions*
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / psychology*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Predictive Value of Tests
  • Quality of Life
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Survival Analysis
  • Survival Rate*