Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_19_3508 - Development of Mental Health Disorders in Endometrial Cancer Survivors and the Impact on Overall Survival - A Population-Based Cohort Study

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Development of Mental Health Disorders in Endometrial Cancer Survivors and the Impact on Overall Survival – A Population-Based Cohort Study
L. M. Burt Jr1, Y. Chen2, V. Deshmukh2, M. Newmann2, K. G. Rowe3,4, J. Snyder2, Y. Wan2, A. Fraser2, K. Smith2, K. Herget2, D. K. Gaffney2, and M. Hashibe2; 1University of Utah Huntsman Cancer Institute, Salt Lake City, UT, 2University of Utah, Salt Lake City, UT, 3Unviersity of Utah, Salt Lake City, UT, 4Intermountain Healthcare, Salt Lake City, UT

Purpose/Objective(s): To assess the risk and outcomes of developing a mental health disorder among endometrial cancer (EC) survivors.

Materials/Methods: Utilizing the Utah Population Database (UPDB), patients with EC greater than 18 years old were identified between 1997 and 2012. Each EC survivor was matched to a general population cancer free individual on birth year, and state of birth (Utah/not Utah) and follow-up time. Mental health disorders were identified by ICD-9 diagnostic codes and EC survivors with pre-existing mental health issues were excluded. The impact of a mental health disorder on overall survival (OS) was examined using cox proportional hazard models.

Results: There were 2,941 EC survivors and 12,192 general population matched subjects that met inclusion criteria with a median follow up time of 7.1 years (range 0 – 19.2) and 7.7 years (0.4 – 19.2) respectively. Clinical characteristics among EC survivors are shown in Table 1. The cumulative incidence of developing a depressive disorder, anxiety disorder or mental illness over a 15 year period was greater in EC survivors than the general population cohort (p <0.0001). Risk factors for developing a mental illness included treatment with tri-modality (surgery, radiation and chemotherapy) and having advanced disease. Being diagnosed after the year 2006, Charlson Comorbidity index of ≥1,having advanced disease and being treated with tri-modality were risk factors for developing anxiety disorders. For depressive disorders, the only risk factor found was having advanced disease.Overall survival was significantly worse in EC survivors who developed a depressive disorder, anxiety disorder or mental illness over a 15 year period (p <0.0001). Table 1
Stage
Local 2267 77.1
Regional 510 17.3
Advanced 164 5.6
Treatment
Surgery only 1893 64.4
Surgery and Radiation 578 19.7
Surgery, Radiation and Chemotherapy 124 4.2
Missing/Other* 346 11.7

Conclusion: EC survivors are at an increased risk of developing mental illnesses compared to the general population. OS was significantly worse in EC survivors who developed a depressive disorder, anxiety disorder or mental illness. This study shows the significance of mental health disorders in EC survivors and the impact on survival.

Author Disclosure: L.M. Burt: Chair; ARRO executive committee. Y. Chen: None. V. Deshmukh: None. M. Newmann: None. K.G. Rowe: None. Y. Wan: None. K. Smith: None. D.K. Gaffney: None. M. Hashibe: Research Grant; NIH.

Lindsay Burt, MD

Disclosure:
Employment
Huntsman Cancer Institute: Radiation Oncologist: Employee; theMednet: Radiation Community Manager: Employee

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