Level 2: Mid-level evidence
The efficacy of psychotherapeutic support was evaluated in a randomized trial of 271 patients having surgery for cancer of the liver/gallbladder, pancreas, colon/rectum, esophagus, or stomach (J Clin Oncol. 2007;25:2702-2708). Patients were randomized to support provided by psychotherapists during both pre- and postoperative hospital stay.
Psychotherapists provided emotional and cognitive support to foster a “fighting spirit” and to diminish “hopelessness and helplessness” and assisted the patient in planning for the future. Comparing psychotherapeutic support vs. usual care, there was 50.7% vs. 33.3% survival at two years (P=.002, NNT 6) and 21.3% vs. 9.6% survival at 10 years (P=.006, NNT 9). The authors of the trial did not reveal their methods for concealment of allocation during the enrollment process, so it is possible that true randomization did not occur.