Quality of Life in the First Year of Follow-Up in a Randomized Multicenter Trial Assessing the Role of Imaging after Radical Surgery of Stage IIB-C and III Cutaneous Melanoma (TRIM Study)

Abstract

The benefit of imaging in the follow-up setting for high-risk melanoma patients is uncertain, and even less is known about the impact of intensive follow-up on the patient´s quality of life. In 2017, a Swedish prospective randomized multicenter study started, in which high-risk melanoma patients are randomly assigned 1:1 to follow-up by physical examinations +/− whole-body imaging. The first-year examinations are scheduled at 0, 6 and 12 months. The aim of this study was to investigate whether the patients´ health-related quality of life (HRQoL) and levels of anxiety and depression were affected at 1 year by imaging. Anxiety/depression and HRQoL were assessed at 0 and 12 months by the questionnaires Hospital Anxiety and Depression (HAD) scale and EORTC QLQ-C30 version 3. Expected baseline QLQ-C30 values for the patients were calculated using data from the general population. In total, 204 patients were analyzed. Mean differences in subscale scores at 1 year were not statistically significant either for HRQoL or for anxiety/depression. Baseline HRQoL did not differ from expected values in the general Swedish population. In conclusion, the patients in general coped well with the situation, and adding whole-body imaging to physical examinations did not affect the melanoma patients’ HRQoL or levels of anxiety or depression.

Oncological surgery follow-up and quality of life: meta-analysis

“…Fewer blood tests and less imaging did not seem to have a negative impact on HRQoL or emotional well-being in most included articles 8 , 29 , 36 , 44 , 45 , 48 . One study 42 comparing conventional hospital follow-up with virtually no follow-up (physical examination every 5 years) found that HRQoL slightly favoured a more intensive approach.…”

“…Four studies, all RCTs, were included with a total of 784 patients in follow-up for melanoma. Sample size ranged from 100 to 297 patients 20 , 29 , 45 , 48 . Three studies were at low risk of bias, and none showed a significant difference in terms of HRQoL, psychological well-being, and patient satisfaction with different follow-up approaches.…”

“…A few studies investigated a reduced-frequency follow-up scheme with fewer follow-up appointments, and less radiographic imaging or other interventions such as a colonoscopy 8 , 29 , 31 , 40 , 42 , 44 , 45 . Five of these studies showed no significant differences regarding HRQoL, emotional well-being or patient satisfaction.…”