Abstract
BACKGROUND: Despite the growth in patient-centered care, multicenter prospective studies investigating satisfaction after skin cancer surgery are limited. OBJECTIVE: To assess trends in esthetic satisfaction, symptoms, and quality of life over 1 year in facial skin cancer patients. METHODS: 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. RESULTS: 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. CONCLUSIONS: Clinical and patient characteristics significantly influence patient-reported outcomes, highlighting the need for personalized treatment approaches to optimize outcomes in dermatologic surgery.