Veldhuizen Inge J, Dusza Stephen W, Kuo Alyce, Aleisa Abdullah, Blue Elliot, Adhikari Sushmita, Nadir Umer, Le Kim, Kazemi Soroush, Sutton Adam V, Nijhawan Rajiv I, Eisen Daniel B, Rossi Anthony M, Srivastava Divya, Wysong Ashley, Nehal Kishwer S, Lee Erica H
Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Dermatology, King Saud University, Riyadh, Saudi Arabia.
J Am Acad Dermatol. 2025 Aug;93(2):444-450. doi: 10.1016/j.jaad.2025.03.022. Epub 2025 Mar 17.
Despite the growth in patient-centered care, multicenter prospective studies investigating satisfaction after skin cancer surgery are limited.
To assess trends in esthetic satisfaction, symptoms, and quality of life over 1 year in facial skin cancer patients.
Patients with facial skin cancer who underwent surgery were enrolled at 4 hospitals across the United States. A total of 990 patients were included. The FACE-Q Skin Cancer questionnaire was administered before surgery, at 2-week, 6-month, and 1-year intervals postsurgery.
Patients reported increased satisfaction with FACE-Q scales over 1 year. Significant factors influencing outcomes included sex, age, history of facial skin cancer, cosmetic surgery, defect size, and cancer location. Males reported higher satisfaction with appearance (P = .003) and scar (P < .001), and reduced psychosocial distress (P < .001). Larger defects were associated with greater psychosocial distress (P = .037) and lower scar appraisal (P = .008). Patients with nose skin cancer reported lower satisfaction with appearance and scars (P = .026, P < .001), higher psychosocial distress (P = .004), and increased cancer worry (P = .045). Patients with cancer near the eyes reported increased cancer worry (P = .004). Reconstruction types did not influence satisfaction.
Clinical and patient characteristics significantly influence patient-reported outcomes, highlighting the need for personalized treatment approaches to optimize outcomes in dermatologic surgery.
尽管以患者为中心的医疗有所发展,但关于皮肤癌手术后满意度的多中心前瞻性研究仍然有限。
评估面部皮肤癌患者1年内的美学满意度、症状及生活质量趋势。
在美国4家医院招募接受手术的面部皮肤癌患者。共纳入990例患者。在手术前、术后2周、6个月和1年时进行《面部皮肤癌患者生活质量问卷(FACE-Q)》调查。
患者报告称在1年中对FACE-Q量表的满意度有所提高。影响结果的显著因素包括性别、年龄、面部皮肤癌病史、整容手术、缺损大小和癌症位置。男性对外观(P = 0.003)和瘢痕(P < 0.001)的满意度更高,心理社会困扰更低(P < 0.001)。更大的缺损与更高的心理社会困扰(P = 0.037)和更低的瘢痕评价(P = 0.008)相关。鼻皮肤癌患者对外观和瘢痕的满意度较低(P = 0.026,P < 0.001),心理社会困扰更高(P = 0.004),癌症担忧增加(P = 0.045)。眼部附近患癌的患者癌症担忧增加(P = 0.004)。重建类型不影响满意度。
临床和患者特征显著影响患者报告的结果,突出了采用个性化治疗方法以优化皮肤科手术结果的必要性。