Psychosocial distress and persistent adverse events in long-term survivors of stage IV melanoma - a cross-sectional questionnaire study

Background: Immune checkpoint inhibitors and targeted therapies have improved survival in patients with stage IV melanoma. However, the challenges faced by long-term survivors remain unclear. The long-term toxicity and psychosocial impact of these treatments in real-world patients have yet to be reported. Material and methods: We conducted a cross-sectional questionnaire study using established screening tools, including the Hornheide Screening Instrument (HSI), the Distress Thermometer (DT) with the National Comprehensive Cancer Network (NCCN) problem list, and melanoma-specific questions addressing persistent adverse events, social impairments, emotional needs, and financial concerns. Results: A total of 159 patients with stage IV melanoma (≥5 years after the initial diagnosis) were enrolled, of whom 93 completed the questionnaire. Approximately one-third of DT/HSI values exceeded the threshold, indicating a need for psycho-oncological support. More than 40% of patients reported persistent treatment-related complaints. Financial and work-related impacts were rare, affecting approximately 8% and 1% of patients, respectively. Conclusions: High rates of psychosocial distress and persistent adverse events were observed, highlighting the need for cancer survivorship programs in the follow-up care of melanoma patients.