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249 Treatment preferences in patients with eye melanoma
  1. MR (Aryana) Shirzada1,2,3,
  2. Arwen H Pieterse2,
  3. Gregorius PM Luyten3,
  4. Coen NR Rasch1,
  5. Nanda Horeweg1,
  6. M Elske van Den Akker-Van Marle2
  1. 1Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

Abstract

Introduction Eye melanomas (depending on location/dimension) are treated with eye removal or with radiotherapy. These treatments are associated with comparable oncological risks, yet they greatly differ in other aspects. Our goal was to investigate how patients weigh various treatment characteristics and outcomes, and to explore what local recurrence rate patients consider acceptable in order to preserve their eye.

Methods An online survey was distributed to treated and to-be-treated eye melanoma patients to elicit treatment preferences using the swing weighting (SW) and treatment trade-off method (TTM). With SW, patients ranked treatment characteristics and subsequently indicated their importance on a scale from 0 (not important at all) to 100 (most important). Using TTM, patients were asked at which local recurrence rate (0–30%) they would prefer eye removal over radiotherapy. Hypothetical local recurrence was set at 0% for eye removal.

Results 123 patients (mean age: 59 years, male: 53%, radiotherapy: 89%, eye removal: 11%) completed both methods. The SW method showed that patients find the risk of tumor recurrence and eye removal most important. Additional hierarchical clustering did not reveal any other specific patterns in perceived importance of treatment characteristics. The TTM showed that 15% of patients did not accept any local recurrence risk, and 66% of patients accepted the highest presented hypothetical local recurrence rate of 30% in order to preserve their eye.

Discussion This study mapped the variation among patients in preferences concerning treatment characteristics, including acceptable local recurrence rate. We also demonstrated the importance of eye and vision preservation, even at the expense of a high local recurrence risk.

Conclusion These findings provide valuable insights on what treatment characteristics patients find important, and can be used when counselling newly-diagnosed patients with eye melanoma.

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