Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Social Work, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Acta Ophthalmol. 2018 Jun;96(4):e421-e426. doi: 10.1111/aos.13655. Epub 2018 Jan 25.
Patients with uveal melanoma (UM) undergo lifelong follow-up as metastases can occur more than 20 years after diagnosis. Little is known about the quality of life (QoL) of UM survivors over such an extended period. To investigate their QoL, we used various estimating factors.
A cohort of patients diagnosed and treated for UM with regularly scheduled follow-up visits was asked to fill in a European Organization for Research and Treatment of Cancer (EORTC) questionnaire comprised of the EORTC QLQ-C30 and EORTC QLQ-OPT30 modules. An additional open question examined other changes in the patients' lifestyle since diagnosis. Independent demographic and medical data were collected from patient records.
Two hundred and thirty-two of 294 patients agreed to complete the questionnaire. General QoL correlated highly with the eye-related QoL. Statistically significant higher QoL was associated with tumours not involving the ciliary body, and with better best-corrected visual acuity (BCVA). A subgroup of 39% of the patients reported severe disability affecting eye-related tasks. Thirty-three per cent were highly concerned about various aspects of their future health. Patients who underwent enucleation reported lower eye-related QoL and described problems related to body image in response to the open question.
General QoL of UM patients is only slightly affected by their malignancy. However, body image and psychosocial adjustment are major issues involved in evaluating QoL. Continuous long-term psychosocial treatment is needed from the time of diagnosis in a subgroup of patients suffering from eye-related disabilities.
葡萄膜黑色素瘤(UM)患者需要终身随访,因为转移可能在诊断后 20 多年发生。对于UM 幸存者在如此长的时间内的生活质量(QoL)知之甚少。为了研究他们的 QoL,我们使用了各种评估因素。
一组定期接受随访的诊断和治疗 UM 的患者被要求填写欧洲癌症研究与治疗组织(EORTC)问卷,其中包括 EORTC QLQ-C30 和 EORTC QLQ-OPT30 模块。另一个开放性问题调查了患者自诊断以来生活方式的其他变化。独立的人口统计学和医学数据从患者记录中收集。
294 名患者中有 232 名同意完成问卷。一般 QoL 与眼部相关 QoL 高度相关。统计学上显著较高的 QoL 与不涉及睫状体的肿瘤以及更好的最佳矫正视力(BCVA)相关。患者中有 39%的人报告存在严重影响眼部相关任务的残疾。33%的人非常关注他们未来健康的各个方面。接受眼球摘除术的患者报告眼部相关 QoL 较低,并在开放性问题中描述了与身体形象相关的问题。
UM 患者的一般 QoL 受其恶性肿瘤的影响较小。然而,身体形象和心理社会调整是评估 QoL 时涉及的主要问题。在遭受眼部相关残疾的患者亚组中,从诊断时起就需要持续的长期心理社会治疗。