Article Text
Abstract
Introduction/Background It is essential to understand quality-of-life after risk-reducing surgery to counsel patients and inform health-economic analysis. The measure preferred by NICE and other guideline committees is EQ-5D, used to generate health-related utility scores, which rank quality-of-life from 0 (death) to 1 (full health). No previous study has reported EQ-5D utility scores for risk-reducing mastectomy (RRM) and risk-reducing salpingo-oophorectomy (RRSO) for breast and ovarian cancer prevention, sourced directly from patients. The aim of this study is to obtain and summarise the best available evidence of EQ-5D utility scores for RRM and RRSO, mapping from other quality-of-life measures.
Methodology We used aggregate data from our previously published systematic review of the literature (PMID 37059410). We converted PCS-12/36 and MCS-12/36 to EQ-5D utility scores using a published mapping algorithm. The study control arm or age-matched country-specific reference values were used for comparison. Random-effects meta-analysis provided adjusted disutilities and utility scores for RRM and RRSO. Subgroup analyses included RRM under vs over 2 years’ follow-up, RRSO under vs over 1 year follow-up, and RRSO in pre- vs post-menopausal women.
Results Four studies (209 patients) reported RRM outcomes using SF-36, five studies (742 patients) reported RRSO outcomes using SF-12/SF-36. RRM is associated with a long-term adjusted disutility of -0.08 (95% CI -0.11, -0.04)(I2 31.4%), and an adjusted utility score of 0.92 (95% CI 0.88, 0.95)(I2 31.4%). RRSO is associated with a long-term adjusted disutility of -0.03 (95% CI -0.05, 0.00)(I2 17.2%) and an adjusted utility score of 0.97 (95% CI 0.94, 0.99)(I2 34.0%).
Conclusion We present the only available EQ-5D utility scores in the literature sourced from patients who have undergone RRM and RRSO. These are highly relevant for counselling patients and for international researchers conducting health-economic analyses of breast and ovarian cancer prevention.
Disclosures No relevant disclosures.