The national comprehensive cancer network distress thermometer as a screening tool for the evaluation of quality of life in uveal melanoma patients

Abstract

Purpose: 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. Methods: 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. Results: 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%. Conclusion: 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.

<p>Screening for Predictive Parameters Requiring Psycho-Oncological Intervention via the National Comprehensive Cancer Network Distress Thermometer in the Follow-Up of Uveal Melanoma Patients</p>

“…In a recent US American study, only a small percentage of uveal melanoma patients reported an existing offer of psychological support and there was vast dissatisfaction with psychological counseling. 3 The percentage of patients that reported pre-existing psychological support was similar to our study (13.3% versus 10.4% of patients 12 ). Yet, reportedly, only a limited number of patients suffering from distress accepts referrals to or turns to psycho-oncological support services with predictors and barriers to psychooncological support service utilization being understudied.…”

“…Details on descriptive patient data, best corrected visual acuity (BCVA) evaluation and calculation of the receiver operating characteristic (ROC)-threshold of the NCCN distress thermometer can be found in Klingenstein et al 2020. 12 This study now adds the important calculation of concrete predictive risk factors of uveal melanoma patients to develop psycho-oncological distress in need of treatment by multivariate correlations and multiple linear regression analysis for clinical routine practice.…”

“…11 In our previous analysis with the NCCN distress thermometer, higher distress levels correlated with lower visual acuity. 12 The NCCN distress thermometer is composed for rapid assessment of psychosocial stress, so-called distress. High patient acceptance, concision and good practicability could be shown in the literature.…”

“…A distress threshold of ≥5 as advised in the literature calling for assistance 13 proved to be sensible for our collective of uveal melanoma patients. 12 We now statistically analysed specific patient characteristics enabling us to potentially identify uveal melanoma patients in danger of developing psycho-oncological distress requiring active intervention by their caregivers via the results of the NCCN distress thermometer.…”

Surgery and Financial Toxicity are Risk Factors for Distress in Cancer Survivors: A Cross-sectional Study

“…[26] McFarland et al reported that 40% of patients with breast cancer had fatigue, the most common physical problem associated with distress. [27] Unlike previous studies, [28,29] in this study nancial di culty was the highest-ranking single item associated with distress. The prevalence of psychological distress and nancial toxicity was 56.5% and 53.1%, respectively.…”