Quality of life of patients with Kaposi Sarcoma: a cross-sectional study

BACKGROUND: Kaposi sarcoma (KS) is an angioproliferative tumor linked to Human Herpesvirus 8 (HHV8) infection, presenting in five clinical variants. While much research has focused on its clinical characteristics and treatment, limited data exist on its psychological impact and effect on quality of life (QoL). This study aims to evaluate the emotional burden of KS in a large cohort of Italian patients. METHODS: A cross-sectional observational study was conducted at a tertiary care center in Milan, Italy, from January to December 2023. Patients with KS were recruited and completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Depression Anxiety Stress Scales short version (DASS-21). Clinical and demographic data were collected, and statistical analysis was performed using logistic regression and Student's t-test to compare QoL scores with general population norms. RESULTS: A total of 121 patients (82.6% male; mean age 75.7 years) participated. The majority (93.3%) had lesions on the lower limbs, with 40.8% presenting visible lesions. Compared to the general population, KS patients had significantly lower cognitive functioning scores (P=0.0217) but higher global health status scores (P=0.0070). Moderate-severe depression, anxiety, and stress were reported in 14.2%, 15.8%, and 15.0% of patients, respectively. Visceral involvement was significantly associated with moderate-severe depression (P=0.013), whereas lesion staging did not correlate with psychological distress. CONCLUSIONS: Despite stable physical health, KS patients experience a significant psychological burden, particularly those with visceral involvement or visible lesions. These findings underscore the need for integrated psychological support to improve coping strategies and overall well-being in KS patients. Future longitudinal studies are warranted to further investigate the evolving psychological impact of KS.