title: Quality of life in the follow-up of uveal melanoma patients after enucleation in comparison to CyberKnife treatment.
abstract: OBJECTIVE
  To compare quality of life (QoL) in patients with uveal melanoma after enucleation and stereotactic radiosurgery to that in an age-matched patient collective.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany. Annemarie.Klingenstein@med.uni-muenchen.de.
authors.forename: A
authors.initials: A
authors.lastname: Klingenstein
authors.affiliation: European CyberKnife® Center, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Fürweger
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Mühlhofer
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany.
authors.forename: S F
authors.initials: SF
authors.lastname: Leicht
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany.
authors.forename: U C
authors.initials: UC
authors.lastname: Schaller
authors.affiliation: European CyberKnife® Center, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Muacevic
authors.affiliation: European CyberKnife® Center, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Wowra
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hintschich
authors.affiliation: Department of Ophthalmology, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-University, Mathildenstraße 8, D-80336, Munich, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Eibl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D016634:Radiosurgery; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014604:Uveal Neoplasms / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000098943:Uveal Melanoma
keywords: CyberKnife; Enucleation; Quality of life; SF-12 Health Survey; Stereotactic radiosurgery; Uveal melanoma