Psychosocial predictors of outcome: time to relapse and survival in patients with early stage melanoma

This study explored psychosocial predictors of relapse and survival in earl y stage melanoma patients. Patients with locoregional melanoma whose tumour thickness exceeded 0.69 mm, seen at the Sydney Melanoma Unit between 1991 and 1996 participated in the study. Questionnaires were sent to participati ng patients every 3 months for 2 years. Domains measured included cognitive appraisal of threat, coping, psychological adjustment, quality of life and perceived aim of treatment. Disease and demographic data were obtained fro m medical records. Multivariate analyses from baseline data used the Cox pr oportional hazards model. Of the 682 patients invited to participate 426 (6 2%) agreed. 91 (21%) relapsed and 60 (14%) died within the follow-up period , that ended in October 1997. After controlling for known prognostic indica tors, several psychosocial variables predicted time to relapse and/or survi val duration. Patients who perceived their aim of treatment to be cured, wh o did not use avoidance as a coping strategy or who were concerned about th eir disease experienced longer periods without relapse. Shorter survival du ration was associated with a positive mood, the use of avoidance as a copin g strategy, not being concerned with their disease and concern about the im pact of the disease on family. There is still much to learn about the poten tial relationships between psychological well being, human behaviours and c ancer outcome. Research in this area needs to clarify the psychological pro cesses, as well as understand the biological and/or behavioural mechanisms that may link them to outcome. (C) 2000 Cancer Research Campaign http://www .bjcancer.com.