Comparative analysis of quality of life in solid organ transplant recipients: the influence of skin cancer

Abstract

Background: Dermatological health-related quality of life (HRQoL) in solid organ transplant recipients (SOTRs), often affected by skin cancer, has been insufficiently explored. This study aimed to evaluate the impact of skin cancer on quality of life (QoL) in SOTRs and to compare HRQoL measures between SOTRs with and without skin cancer.

Methods: This cross-sectional study (June 2023-March 2024) assessed adult SOTRs using the Dermatology Life Quality Index (DLQI) and Skindex-29 questionnaires. For SOTRs with keratinocyte carcinoma (KC), the Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) questionnaire was also administered.

Results: A total of 150 adult SOTRs were included, with 82 having developed post-transplant skin cancer, including melanoma and KCs. DLQI scores were higher in SOTRs with skin cancer, however, the difference was not statistically significant (P ≥ 0.065). SOTRs with skin cancer had higher total Skindex-29 scores (P = 0.012) and "emotion" subscale scores (P = 0.0049), indicating a negative impact on QoL. BaSQoL scores showed a moderate negative effect on QoL, with a higher number of KCs correlating with lower QoL (P < 0.05). Female gender was associated with higher DLQI and BaSQoL diagnosis and treatment scores (P < 0.05).

Conclusions: SOTRs with skin cancer had lower QoL, with greater cancer burden linked to worse outcomes. Female gender was also associated with lower QoL. Tailored management strategies are crucial for this population.

Keywords: Basal and squamous cell carcinoma questionnaire; Dermatology life quality index; Health related quality of life; Keratinocyte carcinoma; Nonmelanoma skin cancer; Quality of life; Skin cancer; Skindex-29; Solid organ transplant recipient.