Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II)
Background and purpose: After reports that complete lymph node dissection (CLND) did not improve melanoma-specific survival of sentinel lymph node (SLN)-positive patients, the use of CLND has diminished but it is still carried out for selected patients. We sought to assess differences in Health-Rela...
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Medical Journals Sweden
2025-02-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42314 |
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| author | Pia J. Heino Jukka Pappinen John F. Thompson Micaela Hernberg Tiina A. Jahkola Mark B. Faries |
| author_facet | Pia J. Heino Jukka Pappinen John F. Thompson Micaela Hernberg Tiina A. Jahkola Mark B. Faries |
| author_sort | Pia J. Heino |
| collection | DOAJ |
| description | Background and purpose: After reports that complete lymph node dissection (CLND) did not improve melanoma-specific survival of sentinel lymph node (SLN)-positive patients, the use of CLND has diminished but it is still carried out for selected patients. We sought to assess differences in Health-Related Quality of Life (HRQoL) and tertiary care costs among the Finnish Multicenter Selective Lymphadenectomy Trial (MSLT)-II-patients.
Patients/materials and methods: A total of 52 patients randomized to CLND and 55 to nodal observation completed a modified version of the standardized and validated, RAND-36 questionnaire at baseline, 4 months and annually up to 5 years. Tertiary care costs between the groups were also compared.
Results: At 60 months, the mean HRQoL score for the CLND and observation groups for General Health were 77.3 versus 65.0 (p = 0.007, adjusted p = 0.065), for role limitations due to physical health 89.5 versus 72.3 (p = 0.029, adjusted p = 0.203) and for role limitations due to emotional problems 91.4 versus 71.9 (p = 0.006, adjusted p = 0.065) and at 48 months, 92.8 versus 71.3 (p = 0.002, adjusted p = 0.056). Median costs per patient were higher in the CLND group at 4 months but the difference disappeared during follow-up.
Interpretation: This study suggests that undergoing CLND after a positive SLN biopsy is not a predictor of worse HRQoL. CLND generates greater costs initially, but there seem to be no major differences in total cost per patient between the two groups.
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| format | Article |
| id | doaj-art-1906130e3c9048a9bbc0151987dab9d0 |
| institution | Kabale University |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-1906130e3c9048a9bbc0151987dab9d02025-02-11T07:18:48ZengMedical Journals SwedenActa Oncologica1651-226X2025-02-016410.2340/1651-226X.2025.42314Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II)Pia J. Heino0https://orcid.org/0000-0003-0024-1915Jukka Pappinen1https://orcid.org/0000-0002-1174-8669John F. Thompson2https://orcid.org/0000-0002-2816-2496Micaela Hernberg3https://orcid.org/0000-0002-0139-4596Tiina A. Jahkola4https://orcid.org/0000-0002-9123-865XMark B. Faries5https://orcid.org/0000-0003-1752-7282Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandFaculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, FinlandThe University of Sydney, Sydney, AustraliaComprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, FinlandDepartment of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandCedars-Sinai Medical Center, Los Angeles, USA; fThe Angeles Clinic & Research Institute, Los Angeles, USABackground and purpose: After reports that complete lymph node dissection (CLND) did not improve melanoma-specific survival of sentinel lymph node (SLN)-positive patients, the use of CLND has diminished but it is still carried out for selected patients. We sought to assess differences in Health-Related Quality of Life (HRQoL) and tertiary care costs among the Finnish Multicenter Selective Lymphadenectomy Trial (MSLT)-II-patients. Patients/materials and methods: A total of 52 patients randomized to CLND and 55 to nodal observation completed a modified version of the standardized and validated, RAND-36 questionnaire at baseline, 4 months and annually up to 5 years. Tertiary care costs between the groups were also compared. Results: At 60 months, the mean HRQoL score for the CLND and observation groups for General Health were 77.3 versus 65.0 (p = 0.007, adjusted p = 0.065), for role limitations due to physical health 89.5 versus 72.3 (p = 0.029, adjusted p = 0.203) and for role limitations due to emotional problems 91.4 versus 71.9 (p = 0.006, adjusted p = 0.065) and at 48 months, 92.8 versus 71.3 (p = 0.002, adjusted p = 0.056). Median costs per patient were higher in the CLND group at 4 months but the difference disappeared during follow-up. Interpretation: This study suggests that undergoing CLND after a positive SLN biopsy is not a predictor of worse HRQoL. CLND generates greater costs initially, but there seem to be no major differences in total cost per patient between the two groups. https://medicaljournalssweden.se/actaoncologica/article/view/42314Malignant melanomasentinel lymph node biopsylymph node excisionlymph node dissectionlymphedema quality of life inventorycost analysis |
| spellingShingle | Pia J. Heino Jukka Pappinen John F. Thompson Micaela Hernberg Tiina A. Jahkola Mark B. Faries Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) Acta Oncologica Malignant melanoma sentinel lymph node biopsy lymph node excision lymph node dissection lymphedema quality of life inventory cost analysis |
| title | Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) |
| title_full | Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) |
| title_fullStr | Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) |
| title_full_unstemmed | Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) |
| title_short | Health-related Quality of Life and hospital costs of Finnish melanoma patients participating in the second Multicenter Selective Lymphadenectomy Trial (MSLT-II) |
| title_sort | health related quality of life and hospital costs of finnish melanoma patients participating in the second multicenter selective lymphadenectomy trial mslt ii |
| topic | Malignant melanoma sentinel lymph node biopsy lymph node excision lymph node dissection lymphedema quality of life inventory cost analysis |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42314 |
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