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Federica Genovesi-Ebert, Clara Meo, Franco Perrone, Clara Meo, Federica Cresti, Patrizia Ferrazza, Stanislao Rizzo; Analysis of the quality of life of patients receiving conservative treatment for uveal melanoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4249.
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Patients (pts) affected by ocular malignant melanoma (MM) may experience distress or changes in their quality of life following treatment . In order identify areas of primary concern, we conducted a crosssectional survey to describe the experiences of ps treated for MM with different therapeutic options .
A total of 130 pts (median age 71 years,range 35-90 y,) treated at Azienda Ospedaliera Universitaria Pisana for MM by using brachitherapy (BRT) with ruthenium 106 plaques and Iodine plaques, stereotatic radiation therapy (SRS) and enucleation participated in this study. We examined quality of life, levels of distress, appearance perceptions, body image, fear of recurrence by using The Quality of Life Scale (QoL) test and the Hospital Anxiety and Depression scale. The results have been analized considering tumor stage, type of treatment, visual and anatomic outcome.
Depressive symptomatology occurred in 6 % of pts analyzed, and 24 % reported a clinically established high level of intrusive thoughts related to melanoma. Quality-of-life scores indicated more disruption on psychological side, compared with social and physical functioning. There are no significant differences at 95% C L with respect to QoL, anxiety, depression and other indices tested among pts who have preserved the eye even though they had lost visual function We appreciated significant differences between pts enucleated and treated conservatively, with regard to anxiety (p = 0.006), QoL (p = 0.012), emotional (p = 0.001) and social functioning (p = 0.05). No statistically significant differences were highlighted between groups of patients treated conservatively by using different therapeutic modalities (BRT vs. SRS) (fig 1)
The pts treated conservatively for ocular MM reported a low level of distress associated with impairment of visual function. Moreover in these subjects anxiety, emotional disorders, fear of recurrence and social functioning deterioration were lower than in the enucleated pts. Therefore eye preservation may play a role in order to achieve a better quality of life. Improvements in patient education prior to surgical intervention may reduce the distress associated with the diagnosis and treatment of melanoma. Psycological preoperative and postoperative support should be useful in patients affectd by MM, especially in patients who will undergo enucleation.
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