QOL (quality of life) を考慮した悪性黒色腫患者の生存時間解析

抄録

A survival analysis of 58 patients with malignant melanoma was performed using the Kaplan-Meier life table method. To take quality of life (QOL) into consideration, we adjusted the survival time by the following equation : quality adjusted life year (QALY)=(survival time)-α × (hospitalization period). When α=0, 0.5, 1, the mean survival time (months) in stage I, II, III, IV was as follows: 60, 60, 40, 19 in α=0; 59, 59, 38, 17 in α=0.5; 59, 59, 35, 15 in α=1 respectively. In stage III, the patients were hospitalized in 12% of overall survival time. In stage IV, the hospitalization period formed 22% of survival time. In _pT_{3, 4}N₀M₀, the mean survival of the patients who received postoperative adjuvant chemotherapy was 60, 59, 58 months in α=0, 0.5, 1, respectively, and the mean survival of the patients who did not receive postoperative adjuvant chemotherapy was 59, 57, 56 months in α=0, 0.5, 1, respectively. The survival rate of the former was 100%, and the latter was 67% in α=0. Since the prognosis of the patients who did not receive adjuvant chemotherapy was poor, hospitalization required in the end stage results in diminished QOL assessed by our methods.