Patient-reported quality of life and aesthetic satisfaction continues to improve for 1-year after Mohs surgery: A multicenter prospective cohort study

J Am Acad Dermatol. 2025 Aug;93(2):444-450. doi: 10.1016/j.jaad.2025.03.022. Epub 2025 Mar 17.

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.

Keywords: patient satisfaction; patient-reported outcomes; skin cancer; surgery.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cicatrix / etiology
  • Cicatrix / psychology
  • Esthetics
  • Facial Neoplasms* / pathology
  • Facial Neoplasms* / psychology
  • Facial Neoplasms* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mohs Surgery* / psychology
  • Patient Reported Outcome Measures*
  • Patient Satisfaction* / statistics & numerical data
  • Prospective Studies
  • Quality of Life*
  • Sex Factors
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / psychology
  • Skin Neoplasms* / surgery
  • Surveys and Questionnaires
  • Time Factors