Figure 2. The Association of Depression on Overall Survival Mediated by Systemic Inflammation and Tumor Response.

Patients with clinically significant depressive symptom scores had higher systemic inflammation indices (SII), higher rates of cancer treatment failure and experienced earlier all-cause mortality. Kaplan-Meier curves depict all-cause mortality for patients with clinical vs subclinical depressive symptom scores. Analyses suggest that early mortality may have been mediated by 2 distinct pathways: through full mediation effects by SII (n = 292) and partial mediation effects by tumor response (n = 394).