BACKGROUND The risk of metastases in uveal melanoma can accurately be estimated through genetic analysis of the tumor. A growing number of patients decide to receive information on their prognosis, although this can be extremely burdensome. Studies on the psychosocial impact of testing are sparse. The objective of this study was to examine traits of patients opting for prognostication, to investigate its psychosocial impact and the use of psycho-oncological services over time. We further examined characteristics of patients utilizing these services and risk factors of prolonged psychological distress. DESIGN AND METHODS This study is a non-randomized controlled prospective clinical observational trial. Patients availing for prognostication formed the test group, while those who opted out constituted the observational group. The psychosocial impact of genetic testing was assessed with the following variables: resilience, social support, fear of tumor progression, depression, general distress, health-related quality of life, estimation of the perceived risk, and the utilization of psycho-oncological interventions. Data were assessed at five different time points over a period of 12 months. We applied binary logistic regression analysis, multiple linear regressions and a mixed model. RESULTS Of 175 patients, 63 decided to obtain prognostic information. Treatment method (enucleation > brachytherapy), lower social support and higher general distress could significantly predict patient's choice for prognostic testing. After result announcement, perceived risk of metastases was significantly increased in patients with poor prognosis, while it decreased in those with good prognosis. Overall, a significant decrease over time appeared concerning fear of progression, general distress, depression and anxiety. Mental quality of life increased over time. The utilization of psycho-oncological interventions increased significantly after prognostication; however, this was equivalent in the test and observational groups. Female sex, higher general distress and higher anxiety predicted greater use of psycho-oncological interventions. DISCUSSION Availing of prognostic testing is not associated with poorer subsequent psychological well-being. It rather may help to alleviate distress and promote a more realistic risk perception. However, psychological support should be available to all patients, independent of prognosis and treatment, especially considering that patients with low social support and high distress increasingly opt for prognostication.

中文翻译：

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葡萄膜黑色素瘤患者预后基因检测的心理社会影响：一项对照前瞻性临床观察研究。


背景技术可以通过肿瘤的遗传分析准确地估计葡萄膜黑色素瘤转移的风险。越来越多的患者决定接收有关其预后的信息，尽管这可能会带来极大的负担。关于测试的社会心理影响的研究很少。本研究的目的是检查选择预测的患者的特征，调查其社会心理影响以及随着时间的推移心理肿瘤服务的使用情况。我们进一步研究了使用这些服务的患者的特征以及长期心理困扰的风险因素。设计和方法本研究是一项非随机对照前瞻性临床观察试验。接受预测的患者构成测试组，而选择退出的患者构成观察组。基因检测的心理社会影响通过以下变量进行评估：复原力、社会支持、对肿瘤进展的恐惧、抑郁、一般痛苦、与健康相关的生活质量、感知风险的估计以及心理肿瘤干预措施的利用。在 12 个月内的五个不同时间点评估数据。我们应用了二元逻辑回归分析、多元线性回归和混合模型。结果 175 名患者中，63 名决定获取预后信息。治疗方法（剜除术 > 近距离放射治疗）、较低的社会支持和较高的总体痛苦可以显着预测患者对预后测试的选择。结果公布后，预后不良的患者的转移风险明显增加，而预后良好的患者的转移风险降低。 总体而言，随着时间的推移，对进展的恐惧、普遍的痛苦、抑郁和焦虑出现了显着下降。心理生活质量随着时间的推移而提高。预测后，心理肿瘤干预措施的使用显着增加；然而，这在测试组和观察组中是相同的。女性、较高的普遍痛苦和较高的焦虑预示着更多地使用心理肿瘤干预措施。讨论 进行预后测试与较差的后续心理健康状况无关。相反，它可能有助于减轻痛苦并促进更现实的风险认知。然而，无论预后和治疗如何，所有患者都应该获得心理支持，特别是考虑到社会支持低和痛苦高的患者越来越多地选择预后。