Gender Differences in Quality of Life and Psycho-Oncological Needs During the First Year After Melanoma Diagnosis.
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OBJECTIVE: This study investigated the course of general well-being and health-related quality of life (HRQoL) in working-age melanoma patients during the first year following diagnosis. It also examines the use of psycho-oncological counseling and rehabilitation, and their impact on QoL. METHODS: Patients aged 18-65 years with stage 0 to IIIC melanoma were eligible for this single-center, prospective cohort study. Following informed consent, clinical data and data on general well-being (WHO-5), HRQoL (FACT-M) and need for psycho-oncological care (Hornheider Screening Instrument) were collected at baseline and every three months over one year. RESULTS: We included 221 melanoma patients (median age 51, range 19-65, 62% female). At baseline, 79% had melanoma stage IB or lower. After one year, 9% had progressed. 38% of patients showed a WHO-5 score below 52% following diagnosis, regardless of tumor stage. Women with stage 0 to IIA melanoma had significantly lower HRQoL in the first six months than men (p = 0.010), and a higher need for psychological support (p < 0.001). There was considerable variability in QoL trajectories both within individuals (median variation 11%) and across patients. In general, 52% needed psycho-oncological care at baseline, but neither counseling (24%) nor rehabilitation (18%) resulted in significant improvements in QoL over the year. CONCLUSIONS: Melanoma diagnosis leads to a marked QoL reduction, particularly in lower stage women, with most patients improving over time. However, substantial intra-individual variation emphasizes the need for regular QoL assessments. Further research is needed to assess the long-term effectiveness of psycho-oncological support and rehabilitation. TRIAL REGISTRATION: German Clinical Trials Register No. DRKS00010005, 08. March 2016.