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Tuesday, 19 October 2004

This presentation is part of: Poster Session - Clinical Strategies; Judgment and Decison Making

QUALITY OF LIFE IMPACT BY MELANOMA AS MEASURED BY UTILITIES

SE Bendeck, MD1, JC Hadley, BA1, P Bonaccorsi, MD1, KM Brown, MD1, DH Lawson, MD2, DR Murray, MD3, CV Washington, MD1, and SC Chen, MD, MS1. (1) Emory University, Department of Dermatology, Atlanta, GA, (2) Emory University, Department of Oncology, Atlanta, GA, (3) Emory University, Department of Surgery, Atlanta, GA

Purpose: The goal of our study was to evaluate the impact of melanoma on patients’ quality of life by calculating utility scores.

Methods: Utilities were elicited with a computer-based time trade-off technique. We established 6 different melanoma health states based on stage (I, II, and III) and time from diagnosis, new (< one year ago) or old (³ one year ago). The patients’ utility score for their melanoma health state was elicited after they were shown a brief presentation of its prognosis, treatment, and reactions of other patients with the same health state. One-way ANOVA and post hoc comparisons were used to analyze mean utilities.

Results: A total of 109 patients (mean age 49.9 years, 56.9% female, and 100% Caucasian) were recruited from our melanoma clinics and database. The following table shows mean utilities, standard deviations, and number of participants for each melanoma health state:

N

Mean Utility (SD)

Stage I

 

 

New (diagnosis < one year ago)

14

0.93 (0.099)

Old (diagnosis ³ one year ago)

69

0.93 (0.11)

 

 

Stage II

 

 

New

3

0.97 (0.058)

Old

8

0.87 (0.16)

 

 

Stage III

 

 

New

7

0.52 (0.31)

Old

8

0.89 (0.13)

Mean utilities for new vs. old diagnoses within the same stage were only significantly different for Stage III (p=0.010). There was also a significant difference in the utilities across new melanoma health states (p<0.001); post hoc analysis demonstrated that the significant differences lie between Stages 1 and 3 (p<0.001) and Stages 2 and 3 (p=0.002). There was no significant difference in the utilities across old melanoma health states.

Conclusions: Although the number of subjects in this preliminary study is small, these results suggest that Stage I melanoma has a relatively small QOL impact. QOL impact increases significantly with stage for new (II vs III and I vs III), but not old diagnoses. Increasing time from initial diagnosis did not significantly affect QOL impact for Stages I and II; however, it did lessen the impact for Stage III. Further work needs to be done to obtain more data, especially for new Stage II diagnoses.


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