Psychological Factors in the Prognosis of Malignant Melanoma: A Prospective Study*

Publisher Website
Google Scholar
Abstract
Patients (64) with clinical stage 1 or 2 malignant melanoma who were apparently disease free rated the amount of adjustment needed to cope with their illness on a scale of 1-100. The resultant figure was called the melanoma adjustment score. Patients (29) who relapsed within 1 yr of surgery reported a score of 53 .+-. 31 (mean .+-. SD); 35 nonrelapsers reported a score of 80 .+-. 20, P < 0.001. Based upon analysis of individual melanoma adjustment scores in the first 31 patients, it was predicted that subjects scoring .gtoreq. 65 would stay in remission, whereas those scoring < 65 would relapse. Applying this prospectively to the next 33 patients, 25 of 33 outcomes (76%), P < 0.03 were correctly identified. This psychological variable was independent of known biological prognostic factors, which did not predict 1 yr survival. The melanoma adjustment score was independent of the number of positive lymph nodes, which did correlate with outcome in these patients. A role for psychological factors in the 1 yr prognosis of this malignancy was suggested.