{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:46:41Z","timestamp":1780087601431,"version":"3.54.0"},"reference-count":10,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"21","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2004,11,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> 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. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> 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. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> 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\u2013negative status yielded a hazard ratio of 0.397 (95% CI, 0.20 to 0.78). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> CEGT does not prolong survival in women with early-stage breast cancer. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2004.12.129","type":"journal-article","created":{"date-parts":[[2004,9,28]],"date-time":"2004-09-28T00:15:27Z","timestamp":1096330527000},"page":"4255-4260","source":"Crossref","is-referenced-by-count":119,"title":["Effect of Cognitive-Existential Group Therapy on Survival in Early-Stage Breast Cancer"],"prefix":"10.1200","volume":"22","author":[{"given":"David W.","family":"Kissane","sequence":"first","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Love","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Hatton","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Bloch","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Clarke","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Miach","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Ikin","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Ranieri","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond D.","family":"Snyder","sequence":"additional","affiliation":[{"name":"From the Memorial Sloan-Kettering Cancer Center, New York, NY; Departments of Medicine and Psychiatry, St Vincent's Hospital; The Peter MacCallum Cancer Institute; The University of Melbourne; and School of Psychology, La Trobe University, Melbourne; and Department of Psychological Medicine and Medical Oncology, Monash Medical Center and Monash University, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc800"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011871"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)11392-2"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199703)6:1<25::AID-PON240>3.0.CO;2-N"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1002\/pon.683"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/0169-2607(91)90122-A"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199811\/12)7:6<508::AID-PON376>3.0.CO;2-7"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199907\/08)8:4<295::AID-PON386>3.0.CO;2-Y"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1990.8.2.356"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026389427983"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2004.12.129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T20:54:26Z","timestamp":1653512066000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2004.12.129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,11,1]]},"references-count":10,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2004,11,1]]}},"alternative-id":["10.1200\/JCO.2004.12.129"],"URL":"https:\/\/doi.org\/10.1200\/jco.2004.12.129","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,11,1]]}}}