Trial reportPloS one2012
Depressive symptoms and cortisol rhythmicity predict survival in patients with renal cell carcinoma: role of inflammatory signaling.
Trial report in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Physiological Rhythms and Biological Variation of Biomolecules: The Road to Personalized Laboratory Medicine.International journal of molecular sciences · 2023Pooled it
- Identifying the unmet supportive care needs of people affected by kidney cancer: a systematic review.Journal of cancer survivorship : research and practice · 2022Pooled it
- Cancer-related inflammation and depressive symptoms: Systematic review and meta-analysis.Cancer · 2022Pooled it
- Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis.Psychoneuroendocrinology · 2017Pooled it
- Addition of Metastasis-Directed Therapy to Intermittent Hormone Therapy for Oligometastatic Prostate Cancer: The EXTEND Phase 2 Randomized Clinical Trial.JAMA oncology · 2023Trial
- The effect of melatonin on sleep and quality of life in patients with advanced breast cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016Trial
- Postsurgical Depressive Symptoms and Proinflammatory Cytokine Elevations in Women Undergoing Primary Treatment for Breast Cancer.Psychosomatic medicine · 2016Trial
- Associations between coping and diurnal cortisol among children affected by parental HIV/AIDS.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2015Trial
- Perceived Stigmatization, Resilience, and Diurnal Cortisol Rhythm Among Children of Parents Living With HIV.Psychological science · 2015Trial
- Randomized controlled trial of expressive writing for patients with renal cell carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2014Trial
- A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation.Brain, behavior, and immunity · 2013Trial
- Trial
- Association between antidepressant exposure and prognosis in breast cancer: A systematic review and meta-analysis.Oncology letters · 2026Article
- Sex differences in the association of emotional approach coping with stress and quality of life among patients with renal cell carcinoma.Palliative & supportive care · 2026Article
- Cross-sectional associations between CES-D scores and the salivary metabolome in nonclinical adults.Discover mental health · 2026Article
- Glucocorticoids in breast cancer: physiologic mechanisms and relationship to risk, survival, and treatment response.Frontiers in endocrinology · 2026Review
- The crosstalk between nerves and immunity: chronic stress as a driver of tumor progression.Frontiers in immunology · 2026Review
- Psychological distress as a putative host-state determinant of cancer immunotherapy response.Frontiers in immunology · 2026Review
- Depression Improves the Predictive Accuracy of the VACS Index 2.0 for All-Cause Mortality Among Sexual Minority Men Living With HIV in the Multicenter AIDS Cohort Study.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Feasibility and acceptability of a mindfulness app-based intervention among patients with metastatic renal cell carcinoma: a multinational study.The oncologist · 2025Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
purposeEvidence has supported the association between psychological factors and cancer biology; however, findings are equivocal on the role of psychosocial factors in cancer progression. This study generates a hypothesis of mechanistic variables by examining the clinical effects of psychosocial factors and cortisol dysregulation in patients with metastatic renal cell carcinoma (RCC) and examines associated activation of transcription control pathways.
methodsPatients with metastatic RCC (n = 217) were prospectively enrolled in this study. Patients completed questionnaires (Centers for Epidemiologic Studies-Depression; SF-36 Health Status Survey; Duke Social Support Index; Coping Operations Preference Enquiry; organized and non-organized religious activity; and intrinsic religiosity), and provided blood and saliva samples. Cortisol levels and whole genome transcriptional profiling were assessed to identify potential alterations in circadian rhythms and genomic pathways.
resultsSeparate Cox regression models, controlling for disease risk category, revealed that CES-D scores (p = 0.05, HR = 1.5, 95% CI for HR: 1.00-2.23) and cortisol slope (p = 0.002; HR = 1.9; 95%CI for HR: 1.27-2.97) were significantly associated with decreased survival. Only cortisol slope and risk category remained significant in the complete model. Functional genomic analyses linked depressive symptoms to increased expression of pro-inflammatory and pro-metastatic genes in circulating leukocytes. 116 transcripts were found to be upregulated by an average of 50% or more in high CES-D patients, and 57 transcripts downregulated by at least 50%. These changes were also found in the tumor in a subset of patients.
conclusionThese findings identify depressive symptoms as a key predictor of survival in renal cell carcinoma patients with potential links to dysregulation of cortisol and inflammatory biology.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.