Details

Autor(en) / Beteiligte

• Lukowiak, Tess M
• Perz, Allison M
• Veerabagu, Surya A
• Lee, Michael P
• Neal, Donald
• Aizman, Leora
• Miller, Christopher J
• Golda, Nicholas
• Albertini, John G
• Holmes, Todd
• Bar, Anna
• Leitenberger, Justin
• Maher, Ian A
• Sobanko, Joseph F
• Chen, David
• Aasi, Sumaira
• Sutton, Adam
• Higgins, 2nd, H William
• Shin, Thuzar M
• Weinberger, Christine
• Mattox, Adam
• Wysong, Ashley
• Etzkorn, Jeremy R

Titel

Patient Quality of Life After Interpolated Flap Repair of Nasal Mohs Surgery Defects: A Multicenter Prospective Cohort Study

Ist Teil von

• JAMA dermatology (Chicago, Ill.), 2021-10, Vol.157 (10), p.1213

Ort / Verlag

United States

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Single-center studies have shown that patients report better skin cancer-specific quality of life (QOL) after Mohs micrographic surgery (MMS), but it is unclear whether this improved QOL applies to patients after MMS and complex reconstruction in cosmetically sensitive areas. To evaluate patient QOL after MMS and interpolation flap reconstruction for patients with nasal skin cancers. This multicenter prospective survey study used the Skin Cancer Index (SCI), a validated, 15-question QOL questionnaire administered at 4 time points: before MMS, 1 week after flap placement, 4 weeks after flap takedown, and 16 weeks after flap takedown. Patients age 18 years or older with a nasal skin cancer who presented for MMS and were anticipated to undergo 2-stage interpolated flap repair by a Mohs surgeon were recruited from August 9, 2018, to February 2, 2020, at 8 outpatient MMS locations across the United States, including both academic centers and private practices. Mean difference in overall SCI score before MMS vs 16 weeks after flap takedown. A total of 169 patients (92 men [54.4%]; mean [SD] age, 67.7 [11.4] years) were enrolled, with 147 patients (75 men [51.0%]; mean [SD] age, 67.8 [11.7] years) completing SCI surveys both before MMS and 16 weeks after flap takedown. Total SCI scores improved significantly 16 weeks after flap takedown compared with pre-MMS scores, increasing by a mean of 13% (increase of 7.11 points; 95% CI, 5.48-8.76; P < .001). All 3 SCI subscale scores (emotion, appearance, and social) improved significantly (emotion subscale, increase of 3.27 points; 95% CI, 2.35-4.18; P < .001; appearance subscale, increase of 1.65 points; 95% CI, 1.12-2.18; P < .001; and social subscale, increase of 2.10 points; 95% CI, 1.55-2.84; P < .001) 16 weeks after flap takedown compared with pre-MMS. Removal of a nasal skin cancer and repair of the resulting defect can be distressing for patients. However, this cohort study suggests that physicians referring patients for MMS can be reassured that their patient's QOL will improve on average after surgery, even when a complex reconstruction is required.