Quality of life in the follow-up of uveal melanoma patients after enucleation in comparison to CyberKnife treatment
To compare quality of life (QoL) in patients with uveal melanoma after enucleation and stereotactic radiosurgery to that in an age-matched patient collective.
QoL was assessed in a cross-sectional survey and compared among 32 uveal melanoma patients after enucleation, 48 patients after stereotactic radiosurgery (CyberKnife®; Accuray® Incorporated, Sunnyvale, CA, USA), and an age-matched control group of 35 patients, using the SF-12 Health Survey. Statistical analysis was performed with Fisher’s exact test, Student’s t test, one-way ANOVA analysis, Wilcoxon rank-sum (Mann–Whitney test), and ordered logistic regression for multivariate analysis.
There was no significant difference in QoL between patients treated by stereotactic radiosurgery and the age-matched control group. After enucleation, patients presented significantly lower values in Physical Functioning (PF), Role Physical (RP), and Role Emotional (RE) compared to the radiosurgery and control group. To control for the overall QoL lowering effect of visual loss, the QoL of the patients who underwent enucleation was compared with the QoL of patients suffering severe functional loss after CyberKnife radiosurgery in a subgroup analysis, which showed no statistically significant difference. The number of comorbidities had a significant impact on QoL in multivariate analysis.
Superior performance in PF, RP, and RE suggests that CyberKnife represents a suitable first-line therapy for uveal melanoma. In cases with painful amaurosis or vast tumor recurrence, enucleation can be performed with an acceptable QoL outcome.
KeywordsQuality of life SF-12 Health Survey Enucleation Stereotactic radiosurgery CyberKnife Uveal melanoma
Compliance with ethical standards
No funding was received for this research.
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
- 6.Diener-West M, Earle JD, Fine SL, Hawkins BS, Moy CS, Reynolds SM, Schachat AP, Straatsma BR, Collaborative Ocular Melanoma Study Group (2001) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, III: initial mortality findings. COMS Report No. 18. Arch Ophthalmol 119(7):969–982CrossRefPubMedGoogle Scholar
- 18.Ware JE, Kosinski M, Keller SD (1995) How to Score the SF-12 Physical and Mental Health Summary Scales, 2nd edn. The Health Institute, New England Medical Center, BostonGoogle Scholar
- 26.Melia M, Moy CS, Reynolds SM, Hayman JA, Murray TG, Hovland KR, Earle JD, Kurinij N, Dong LM, Miskala PH, Fountain C, Cella D, Mangione CM, Collaborative Ocular Melanoma Study-Quality of Life Study Group (2006) Quality of life after iodine 125 brachytherapy vs enucleation for choroidal melanoma: 5-year results from the Collaborative Ocular Melanoma Study: COMS QOLS Report No. 3. Arch Ophthalmol 124(2):226–238CrossRefPubMedGoogle Scholar
- 29.Stewart AL, Ware JE (1992) Measuring Functioning and Well-Being: The Medical Outcome Study Approach. Duke University Press, DurhamGoogle Scholar
- 30.Sprangers MAG, Cull A, Groenvold M (1998) EORTC Quality of Life Study Group Guidelines for Developing Questionnaire Modules. EORTC, BrusselsGoogle Scholar