Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany.
Acta Ophthalmol. 2020 May;98(3):e381-e387. doi: 10.1111/aos.14277. Epub 2019 Oct 25.
To assess quality of life (QoL) status via the National Comprehensive Cancer Network (NCCN) distress thermometer as a psychooncological screening tool in uveal melanoma patients.
One hundred and six consecutive patients suffering from uveal melanoma completed the distress thermometer between 04/2018 and 12/2018. Practical, emotional, family concerned, spiritual, physical and overall distress levels, distribution of distress and subgroup analyses defining groups of potential high distress levels in need of intervention were assessed. Descriptive statistics, cross-tabulations, chi-square and Fisher's exact test as well as correlation coefficients (Spearman's rho) and receiver operating characteristic (ROC) were used for analysis.
Patients with higher T-category had significantly more emotional problems and spiritual concerns (p = 0.046 and p = 0.023, respectively). Female patients accounted for higher rates of physical issues (p = 0.034). Lower best corrected visual acuity (BCVA) was correlated with higher distress levels (p = 0.037). Patients resulting in loss of BCVA of ≥3 lines reported higher distress levels (p = 0.029). A distress threshold of 5 on the basis of ROC analysis showed a corresponding sensitivity of 100% and specificity of 76%.
The NCCN distress thermometer could be integrated well into our clinical routine and proved to be a rapid, yet sensible screening tool for emotional and physical distress in patients with uveal melanoma. Special attention should be paid to patients with higher T-category and patients resulting in lower levels of BCVA. As in patients with different tumour entities, the established distress threshold of ≥5 proposing intervention proved to be adequate for uveal melanoma patients.
使用美国国家综合癌症网络(NCCN)苦恼温度计作为一种心理肿瘤学筛查工具,评估葡萄膜黑色素瘤患者的生活质量(QoL)状况。
2018 年 4 月至 12 月期间,106 例葡萄膜黑色素瘤患者连续完成了苦恼温度计的测试。评估了实际困扰、情绪困扰、家庭困扰、精神困扰、身体困扰和总体困扰水平,困扰的分布以及亚组分析,确定需要干预的潜在高困扰水平的分组。采用描述性统计、交叉表、卡方检验和 Fisher 精确检验以及相关系数(Spearman's rho)和接收者操作特征(ROC)进行分析。
T 分期较高的患者表现出更明显的情绪问题和精神困扰(p=0.046 和 p=0.023)。女性患者表现出更多的身体问题(p=0.034)。更好矫正视力(BCVA)越低与更高的困扰水平相关(p=0.037)。BCVA 损失≥3 行的患者报告了更高的困扰水平(p=0.029)。基于 ROC 分析的 5 分苦恼阈值显示出相应的敏感性为 100%,特异性为 76%。
NCCN 苦恼温度计可以很好地整合到我们的临床常规中,并且已被证明是一种快速而敏感的筛查工具,可用于评估葡萄膜黑色素瘤患者的情绪和身体困扰。应特别关注 T 分期较高的患者和导致 BCVA 降低的患者。与不同肿瘤实体的患者一样,≥5 分的既定苦恼阈值建议干预对葡萄膜黑色素瘤患者也是合适的。