This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boesen, E. H. Articles by Johansen, C. Search for Related Content PubMed PubMed Citation Articles by Boesen, E. H. Articles by Johansen, C. Related Articles Related Editorial Social Bookmarking                            What's this?

Survival After a Psychoeducational Intervention for Patients With Cutaneous Malignant Melanoma: A Replication Study

Ellen H. Boesen, Sidsel H. Boesen, Kirsten Frederiksen, Lone Ross, Karin Dahlstrøm, Grethe Schmidt, Jesper Næsted, Christen Krag, Christoffer Johansen

From the Institute of Cancer Epidemiology, Danish Cancer Society; Department of Plastic Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej, Copenhagen County; Department of Plastic Surgery and Burn Unit, Rigshospitalet, University of Copenhagen, Copenhagen; and the Department of Plastic and Recunstructive Surgery, Roskilde University Hospital, Roskilde, Denmark

Address reprint requests to Ellen H. Boesen, MD, Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; e-mail: ellen{at}cancer.dk

Purpose The results of a randomized, intervention study done in 1993 of psychoeducation for patients with early-stage malignant melanoma showed a beneficial effect on recurrence and survival 6 years after the intervention. In the present study, we replicated the study with 258 Danish patients with malignant melanoma. We also compared recurrence and survival among the participants in the randomized study with 137 patients who refused to participate.

Patients and Methods We randomly assigned 262 patients with primary malignant melanoma to a control or an intervention group. Patients in the intervention group were offered six weekly 2-hour sessions of psychoeducation. Participants and nonparticipants were followed up for vital status and recurrence 4 to 6 years after surgical treatment. Prognostic factors (thickness of the tumor and lymph node status), sex, and age were adjusted for in a Cox regression model (proportional hazards regression) to derive an adjusted survival rate ratio and an adjusted relapse-free survival rate ratio, with 95% CIs.

Results The hazard ratio was 1.30 (95% CI, 0.5 to 3.5) for survival and 0.73 (95% CI, 0.3 to 1.9) for recurrence. Being a nonparticipant increased the risk for death by more than two-fold (hazard ratio, 2.26; 95% CI, 1.0 to 5.2) over that of participants.

Conclusion Psychoeducation did not increase survival or the recurrence-free interval among patients with malignant melanoma; however, nonparticipants had a statistically significantly greater risk for death than participants.

Supported by the Psychosocial Research Committee, The Danish Cancer Society (Grants No. 9722559 and PP01016) and the IMK Foundation (Grant No. 5322569).

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

Related Editorial

• Letting Go of the Hope That Psychotherapy Prolongs Cancer Survival
  David W. Kissane
  JCO 2007 25: 5689-5690 [Full Text]

This article has been cited by other articles:

				D. Cornish, C. Holterhues, L. V. van de Poll-Franse, J. W. Coebergh, and T. Nijsten A systematic review of health-related quality of life in cutaneous melanoma Ann. Onc., August 1, 2009; 20(suppl_6): vi51 - vi58. [Abstract] [Full Text] [PDF]

				D. X. Vo and M. J. Park Stress and Stress Management Among Youth and Young Men American Journal of Men's Health, December 1, 2008; 2(4): 353 - 366. [PDF]

				D. W. Kissane Letting Go of the Hope That Psychotherapy Prolongs Cancer Survival J. Clin. Oncol., December 20, 2007; 25(36): 5689 - 5690. [Full Text] [PDF]