Abstract
Purpose: :
Uveal melanoma (UM) patients need life-long follow-up since metastases can occur even more than 15 years after diagnosis. Little is known about the quality of life (QOL) of UM survivors for such a long period. The purpose of this study is to describe the QOL of UM survivors as a factor of age, diagnosis, time since diagnosis, primary treatment, overall best corrected visual acuity (BCVA), and BCVA in the melanoma eye.
Methods: :
A cohort of 294 patients who were treated for UM was asked to fill a questionnaire comprised of the EORTC QLQ-C30 and EORTC QLQ-OPT30 modules. The questionnaire was completed during a regular clinic visit. Answers ranged from 1 (completely unaffected) to 4 (severely affected). An open question requested a description of other changes in the patient's life since diagnosis. Independent demographic and medical variables were collected from medical records.
Results: :
From January through August 2007, 232 of 294 patients agreed to complete the questionnaire. The mean score for general QOL and eye-related QOL were high: 1.5 ± 0.52 and 1.67 ± 0.52 (mean ± SD) respectively. General QOL was highly correlated to eye-related QOL (F=207.26, p<0.0001) in an almost 1:1 relationship. Older age, a tumor not involving the ciliary body, and better BCVA were associated with statistically significant higher QOL. A subgroup of 39% of the patients reported severely affected eye-related tasks. Thirty-three percent were highly concerned about different aspects of their future health (e.g. recurrence or metastases). Patients after local resection or enucleation reported slightly higher eye-related QOL, although in response to the open question described problems related to body image.
Conclusions: :
General QOL of UM patients is slightly affected by their malignancy. As eye-related QOL decreases, so does general QOL. Body image and psycho-social adjustment should be considered in evaluating QOL. The subgroup of patients who do suffer from their eyes is in need of psycho-social intervention not only after diagnosis but also on a continuing basis. All patients need information about physical and psycho-social implications of treatment in the short and long term.
Keywords: oncology • quality of life • tumors