Utility Scores for Risk-Reducing Mastectomy and Risk-Reducing Salpingo-Oophorectomy: Mapping to EQ-5D

Samuel G Oxley; Xia Wei; Michail Sideris; Oleg Blyuss; Ashwin Kalra; Jacqueline J Y Sia; Subhasheenee Ganesan; Caitlin T Fierheller; Li Sun; Zia Sadique; Haomiao Jin; Ranjit Manchanda; Rosa Legood

doi:10.3390/cancers16071358

Utility Scores for Risk-Reducing Mastectomy and Risk-Reducing Salpingo-Oophorectomy: Mapping to EQ-5D

Cancers (Basel). 2024 Mar 30;16(7):1358. doi: 10.3390/cancers16071358.

Authors

Samuel G Oxley^{1

2}, Xia Wei^{1

3}, Michail Sideris^{1

2}, Oleg Blyuss^{1

4}, Ashwin Kalra^{1

2}, Jacqueline J Y Sia^{1

2}, Subhasheenee Ganesan^{1

2}, Caitlin T Fierheller¹, Li Sun³, Zia Sadique³, Haomiao Jin⁵, Ranjit Manchanda^{1

2

3

6}, Rosa Legood^{1

3}

Affiliations

¹ Wolfson Institute of Population Health, Queen Mary University of London, London EC1M 6BQ, UK.
² Department of Gynaecological Oncology, Barts Health NHS Trust, Royal London Hospital, London E1 1BB, UK.
³ Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
⁴ Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child´s Health, Sechenov First Moscow State Medical University, Sechenov University, Moscow 119991, Russia.
⁵ School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK.
⁶ MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK.

Abstract

Background: Risk-reducing mastectomy (RRM) and risk-reducing salpingo-oophorectomy (RRSO) are the most effective breast and ovarian cancer preventive interventions. EQ-5D is the recommended tool to assess the quality of life and determine health-related utility scores (HRUSs), yet there are no published EQ-5D HRUSs after these procedures. These are essential for clinicians counselling patients and for health-economic evaluations.

Methods: We used aggregate data from our published systematic review and converted SF-36/SF-12 summary scores to EQ-5D HRUSs using a published mapping algorithm. Study control arm or age-matched country-specific reference values provided comparison. Random-effects meta-analysis provided adjusted disutilities and utility scores. Subgroup analyses included long-term vs. short-term follow-up.

Results: Four studies (209 patients) reported RRM outcomes using SF-36, and five studies (742 patients) reported RRSO outcomes using SF-12/SF-36. RRM is associated with a long-term (>2 years) disutility of -0.08 (95% CI -0.11, -0.04) (I² 31.4%) and a utility of 0.92 (95% CI 0.88, 0.95) (I² 31.4%). RRSO is associated with a long-term (>1 year) disutility of -0.03 (95% CI -0.05, 0.00) (I² 17.2%) and a utility of 0.97 (95% CI 0.94, 0.99) (I² 34.0%).

Conclusions: We present the first HRUSs sourced from patients following RRM and RRSO. There is a need for high-quality prospective studies to characterise quality of life at different timepoints.

Keywords: mapping; risk-reducing mastectomy; risk-reducing salpingo-oophorectomy; utility scores.

Abstract

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