The health-related quality of life of long-term survivors of melanoma treated with isolated limb perfusion.
OBJECTIVE
To evaluate the generic and condition-specific health-related quality of life (HRQL) of long-term survivors of extremity melanoma treated with isolated limb perfusion (ILP).


METHODS
Between 1978 and 2001, 292 patients with melanoma of the limbs underwent ILP in our institution. Of these patients, 59 were alive and disease-free for at least six months prior to study entry. Fifty-one of these 59 patients completed a mailed questionnaire assessing generic HRQL (SF-36), condition-specific HRQL (limb function, cosmetic results, fear of recurrence), and problems regarding work and insurance. An age- and gender-matched, normative sample of the Dutch general population was available for comparison of SF-36 scores.


RESULTS
Mean age of patients was 57 years, 90% female, with a median time since ILP of 14 years (range 3-25 years). The SF-36 scores of the patient group were equal to or better than that of the general population, significantly for bodily pain, general health perceptions, and the physical and mental health component scores. Nevertheless, the patients reported a number of specific problems: complaints of limb function were reported by 49-55%, cosmetic problems by 31-38% and fear of local disease recurrence and distant metastases by 77 and 63% of the patients, respectively. Less than 10% of patients reported problems in obtaining a mortgage or life insurance.


CONCLUSIONS
The HRQL of long-term survivors of melanoma treated with ILP appears comparable to, and sometimes better than that of healthy peers within the general population. Nevertheless, this survivor group reports a number of specific problems that impact on daily life. Although these findings need to be confirmed with larger, prospective studies, they suggest that rehabilitation should focus on improving limb functionality, and addressing chronic fear of disease recurrence.
Noorda
E M
EM
Department of Surgical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. cheno@slz.com
van Kreij
R H J
RH
Vrouenraets
B C
BC
Nieweg
O E
OE
Muller
M
M
Kroon
B B R
BB
Aaronson
N K
NK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016022:Case-Control Studies; D010478:Chemotherapy, Cancer, Regional Perfusion; D018572:Disease-Free Survival; D004954:Esthetics; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D035002:Lower Extremity / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000523:psychology* / Q000556:secondary; D008603:Mental Health; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D017741:Survivors / Q000523:psychology*; D034941:Upper Extremity / Q000473:pathology* / Q000503:physiopathology