Tumor Burden and Health-Related Quality of Life in Patients with Melanoma In-Transit Metastases

SIMPLE SUMMARY: Little research has investigated how patients with melanoma in-transit metastases (ITM) experience their health-related quality of life (HRQOL). This study aimed to investigate the association between sex, age, tumor burden, and HRQOL in treatment-naïve melanoma patients with ITM. Ninety-five patients were included in this study from Sweden. The Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire was used to assess HRQOL. The FACT-M consists of FACT-G (General) with the subscales PWB (Physical Well-Being), SWB (Social Well-Being), EWB (Emotional Well-Being), and FWB (Functional Well-Being) together with the melanoma-specific scales MS (Melanoma Subscale) and MSS (Melanoma Surgery Subscale). The results showed that the female sex and having more than 10 tumors were significantly associated with lower HRQOL in patients with ITM. ABSTRACT: Background: Few studies have investigated the health-related quality of life (HRQOL) in patients with melanoma in-transit metastases (ITM). The aim was to investigate the association between tumor burden and HRQOL, including disparities pertaining to sex and age, in treatment-naïve patients with ITM. Methods: Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire was used to assess HRQOL Pairwise comparisons using t-tests between clinical cutoffs are presented and multiple linear regression analysis showing the unique associations of gender, age, number of tumors, tumor size, presence of lymph node metastases, and tumor localization. Results: A total of 95 patients, 47% females and 53% males (median age 72 years) were included between 2012 and 2021. Women scored significantly lower on emotional well-being (p = 0.038) and lower on FACT-M (p = 0.058). Patients who had ≥10 tumors scored significantly lower on FACT-M (p = 0.015), emotional- and functional well-being (p = 0.04, p = 0.004, respectively), melanoma scale (p = 0.005), and FACT-G (p = 0.027). There was no significant difference in HRQOL depending on age, size of tumors, localization, or presence of lymph node metastases. Conclusion: For patients with melanoma ITMs, the female sex and higher tumor burden (i.e., number of tumors) were significantly correlated with lower HRQOL. However, these findings do not fully explain HRQOL for this patient population, and future research should consider the possibility that there are specific questions for patients with ITM where current instruments might fail to measure their discomfort to the full extent.