Higher Social Attachments Associated with Survival Advantage in Women with Ovarian Cancer
Previously, a relationship between disease-related biomarkers—including markers of inflammation, angiogenesis, invasion, and innate immunity, as well as cellular markers of gene expression—and social support has been demonstrated in patients with ovarian cancer; however, whether these findings are clinically relevant to patient outcomes remains unknown. This study focused on two types of support, “social attachment, a type of emotional social support reflecting connections with others, and instrumental social support, reflecting the availability of tangible assistance,” to determine how long-term survival might be affected, noted Susan K. Lutgendorf, PhD, of the University of Iowa, Iowa City, IA, and colleagues.
“We hypothesized that patients reporting higher levels of social attachment at the time of diagnosis would have a survival advantage compared with patients with lower levels of social attachment,” she noted. The investigators recruited 168 patients with historically confirmed epithelial ovarian cancer who completed surveys prior to surgery and were subsequently observed from surgery until death or December 2010. Psychosocial assessments were completed before surgery, at 6 months, and at 1 year using two subscales of the 24-item self-report Social Provisions Scale (SPS), emotional closeness and reliable alliance.
After adjusting for disease stage, grade, histology, residual disease, and age, greater social attachment was associated with a lower likelihood of death (HR, 0.87; 95% CI, 0.77 to 0.98; P=0.018). Median survival for patients with low social attachment, categorized on a median split of 15, with ≥15 indicating high social attachment and <15, low social attachment, was 3.35 years (95% CI, 2.56 to 4.15 years). A total of 59% of patients with high social attachment were alive after 4.70 years, at study completion. Instrumental social support and survival were not significantly associated.
Since no significant difference in marital relationship distribution across social attachment groups was found,” sources of social attachment and its survival benefits remain a significant topic for future research,” they noted.
“These findings are the first to link a facet of the social environment with survival in a homogeneous ovarian cancer population and establish the clinical relevance of our previous reports linking social environmental factors with intermediate biomarkers in ovarian cancer,” the investigators concluded. “Clinical implications include the importance of screening for deficits in the social environment and consideration of support activities during adjuvant treatment.”