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. 2023 Jul;32(7):1114-1121.
doi: 10.1002/pon.6165. Epub 2023 May 20.

Appearance-related psychosocial distress after facial non-melanoma skin cancer surgery: A 1-year prospective study

Valérie D'Hondt  1 , Inge J Veldhuizen  1   2 , F F M Theelen  1 , Stéphanie Herlaar  1 , Erica H Lee  2 , Saskia Houterman  3 , Tjinta Brinkhuizen  4 , Maarten M Hoogbergen  1
Affiliations

Appearance-related psychosocial distress after facial non-melanoma skin cancer surgery: A 1-year prospective study

Valérie D'Hondt et al. Psychooncology. 2023 Jul.

Abstract

Objective: Patients undergoing Mohs Micrographic Surgery (MMS) for facial non-melanoma skin cancer (NMSC) experience appearance-related psychosocial distress due to its post-surgical esthetic changes. However, little is known about its development over a longer follow-up period. This study prospectively assessed appearance-related psychosocial distress in patients undergoing MMS for facial NMSC over a 1-year follow up period.

Methods: Patients who had MMS for facial NMSC between September 2020 and October 2021 were invited to answer the FACE-Q Skin Cancer - appearance-related psychosocial distress scale preoperatively, 2 weeks, 6 months, and 1 year after surgery.

Results: A total of 217 patients completed the questionnaire at baseline. In addition, 158 (72.8%), 139 (64.1%), and 120 (55.3%) questionnaires were successfully answered 2 weeks, 6 months, and 1 year after surgery, respectively. Patients with a peripheral lesion presented higher appearance-related psychosocial distress scores at baseline than patients with a central lesion (p = 0.02). There was a decreasing trend in appearance-related psychosocial distress over time, but without a significant result (baseline-2-week; p = 0.73, 2-week-6-month; p = 0.80, 6-month-1-year; p = 0.17, baseline-1-year; p = 0.23). Patients with secondary intention healing and graft reconstruction methods experienced more appearance-related psychosocial distress over time than patients with primary wound closures (p = 0.03).

Conclusions: Patients still experience appearance-related psychosocial distress 1 year after MMS. These patients may benefit from targeted counseling. Additionally, predictors of more appearance-related psychosocial distress, such as secondary intention healing and graft reconstruction methods, may benefit from additional psychological care.

Keywords: Mohs Micrographic Surgery; appearance-related psychosocial distress; nonmelanoma skin cancer; patient-reported outcome; psycho-oncology.

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