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Effectiveness of adjuvant supportive-expressive group therapy for breast cancer

Breast Cancer Research and Treatment volume 180, pages 121–134 (2020)Cite this article

Abstract

Purpose

Randomized control trials exploring adjuvant supportive-expressive group therapy (SEGT) for breast cancer have yielded conflicting survival results. This retrospective cohort study was designed to explore the association of adjuvant SEGT performed at diagnosis with survival in real-world patients.

Methods

3327 patients with breast cancer were divided between those who received oncologic treatment combined with SEGT-based intervention (referred to as BRBC [n = 354]) and those who only received oncologic treatment (referred to as OT [n = 2973]). Primary outcome was overall survival (OS) at 1-year, 3-year, 5-year. Propensity score-matched analysis (at a ratio of 1:3) and instrumental variable analysis (IVA) were performed.

Results

The median overall survival was 7.3 years (95% CI 7.0–7.7 years) in BRBC and 7.1 years (95% CI 6.9–7.4 years) in OT. BRBC was not significantly associated with improved 1-year (HR 0.74, 95% CI 0.49–1.10, P = 0.1748; NNT = 44.8, 95% CI − 118.5 to 22.6), 3-year (HR 0.98, 95% CI 0.75–1.27, P = 0.8640; NNT = 273.7, 95% CI − 21.0 to 21.3), or 5-year survival (HR 0.79, 95% CI 0.61–1.02, P = 0.0908; NNT = 36.0, 95% CI − 384.5 to 19.1) compared with OT. IVA indicated that BRBC had a survival benefit over OT in the 1-year, 3-year, and 5-year of 1.5% (95% CI 1.2–1.9%), 0.7% (95% CI 0.6–0.8%), and 2.6% (95% CI 2.0–3.4%), respectively.

Conclusion

Adjuvant SEGT cannot significantly prolong 5-year survival in breast cancer, though a longer observation period is warranted according to the marginal survival benefit identified at the end of the follow-up.

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Funding

This research was funded by grants from National Natural Science Foundation of China (No. 71904033), Humanity and Social Science Youth Foundation of Ministry of Education (No. 19YJCZH227), Medical Scientific Research Foundation of Guangdong Province (No. A2019484), Research Fund for Talented Scholars of Guangzhou University of Chinese Medicine (No. A1-AFD018), and Innovative Project of Guangzhou University of Chinese Medicine (No. 2016KYTD08).

Author information

Author notes

  1. Zeng Jie Ye and Zhang Zhang have contributed equally to this work and are co-first authors.

Affiliations

  1. Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China

    Zeng Jie Ye

  2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, China

    Zhang Zhang

  3. The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 510275, Guangdong Province, China

    Xiao Ying Zhang

  4. Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China

    Ying Tang

  5. Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China

    Jian Liang

  6. The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China

    Zhe Sun

  7. Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China

    Mu Zi Liang

  8. South China University of Technology, Guangzhou, 510641, Guangdong Province, China

    Yuan Liang Yu

Authors
  1. Zeng Jie Ye
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Contributions

ZJY conceptualized and designed the study, carried out the initial analyses, supervised data collection, drafted the initial manuscript, and approved the final manuscript as submitted. ZZ carried out the initial analyses, supervised data collection, drafted the initial manuscript, and approved the final manuscript as submitted. XYZ supervised data collection, coordinated data collection, drafted the initial manuscript, and approved the final manuscript as submitted. YT coordinated data collection, drafted the initial manuscript, and approved the final manuscript as submitted. JL coordinated data collection, drafted the initial manuscript, and approved the final manuscript as submitted. ZS coordinated data collection, critically reviewed the manuscript, drafted the initial manuscript, and approved the final manuscript as submitted. MZL coordinated data collection, critically reviewed the manuscript, drafted the initial manuscript, and approved the final manuscript as submitted. YL coordinated data collection, critically reviewed the manuscript, drafted the initial manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Zeng Jie Ye.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ye, Z.J., Zhang, Z., Zhang, X.Y. et al. Effectiveness of adjuvant supportive-expressive group therapy for breast cancer. Breast Cancer Res Treat 180, 121–134 (2020). https://doi.org/10.1007/s10549-020-05526-4

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Keywords

  • Breast cancer
  • Supportive-expressive group therapy
  • Resilience
  • Survival
  • Instrumental variable
  • Propensity analysis