Patient-Reported Outcomes and Factors Associated With Patient Satisfaction After Surgical Treatment of Facial Nonmelanoma Skin Cancer

Sasor, Sarah E.; Cook, Julia A.; Loewenstein, Scott N.; Wooden, William A.; Cohen, Adam S.; Chu, Michael; Tholpady, Sunil S.

doi:10.1001/jamasurg.2018.3534

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…The nose and periorbital regions are important esthetic features of the face, and defects can severely impact patients’ self-esteem and quality of life 27. Nasal and periorbital defects pose unique challenges for reconstructive surgeons due to irregular contours, nonuniform skin thickness, and functional requirements of this region.…”

Section: Discussionmentioning

confidence: 99%

“…The nose and periorbital regions are important esthetic features of the face, and defects can severely impact patients' self-esteem and quality of life. 27 Nasal and periorbital defects pose unique challenges for reconstructive surgeons due to irregular contours, nonuniform skin thickness, and functional requirements of this region. Although local and rotational flaps have utility in the reconstruction of smaller defects, forehead flaps are the mainstay reconstructive modality for sizable defects.…”

Section: Discussionmentioning

confidence: 99%

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Development of a Risk Prediction Model for Complications Following Forehead Flaps for Nasal and Periorbital Reconstruction

Patel

Oladeji

et al. 2022

Journal of Craniofacial Surgery

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Background: Forehead flaps are a workhorse for nasal reconstruction, but complications occur in up to 30% of patients and risk factors are not well characterized. This study aimed to identify risk factors for complications, and provide clinicians a method to stratify patient risk to facilitate shared decision-making. Materials and Methods: This retrospective study included patients who underwent forehead flaps between 2007 and 2020. Demographic and treatment characteristics were abstracted, in addition to clinical outcomes data. Multivariable regression was conducted, with step-wise variable elimination to determine inclusion in the final model. From the final regression, a risk-stratification scheme was developed. Results: One hundred ninety-seven patients underwent forehead flap reconstruction, with a mean age of 68.5 years. Mean follow-up time was 42 months. There were 50 (25.4%) patients who developed a complication, including impaired nasal function (18.8%), flap congestion (5.1%), infection (2.5%), poor donor site healing (2.5%) wound dehiscence (2.0%), and flap congestion (1.5%). On univariate analysis, female sex, immunosuppression, prior radiotherapy, and larger resection area were associated with complications (P<0.05). On multivariable analysis, female sex [odds ratio (OR): 3.89, P<0.001], hypoalbuminemia (OR: 3.70, P=0.01), and prior wide local excision (OR: 3.62, P=0.04) were predictors of complications. A clinical calculator was developed incorporating these risk factors, with a C-statistic of 0.85, indicating strong predictive value. Conclusions: We conducted the most comprehensive review of risk factors for the development of complications after forehead flap reconstruction. From this analysis, a novel, implementable, risk-stratification scheme was developed to equip surgeons with the ability to provide individualized risk assessment to patients and address preoperative comorbidities to optimize outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of a Risk Prediction Model for Complications Following Forehead Flaps for Nasal and Periorbital Reconstruction

Patel

Oladeji

et al. 2022

Journal of Craniofacial Surgery

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“…However, this study was limited by its cross‐sectional study design, in which no baseline appearance‐related psychosocial distress scores were obtained. Therefore, this study's objective is to prospectively analyze long‐term appearance‐related psychosocial distress in patients who underwent MMS for facial NMSC, using the FACE‐Q Skin Cancer module 27–29 …”

Section: Introductionmentioning

confidence: 99%

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

D’Hondt,

Veldhuizen,

Theelen

et al. 2023

Psycho-Oncology

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Objective: Patients undergoing Mohs Micrographic Surgery (MMS) for facial nonmelanoma 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 -appearancerelated 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-1year; 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).

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Quality-of-Life Outcomes for Excision and Reconstruction of Periocular Nonmelanoma Skin Cancer

Kinde

Idowu

Ashraf

et al. 2024

Facial Plastic Surgery & Aesthetic Medicine

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Patient-Reported Outcomes and Factors Associated With Patient Satisfaction After Surgical Treatment of Facial Nonmelanoma Skin Cancer

Abstract: Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Cited by 4 publications

References 6 publications

Development of a Risk Prediction Model for Complications Following Forehead Flaps for Nasal and Periorbital Reconstruction

Development of a Risk Prediction Model for Complications Following Forehead Flaps for Nasal and Periorbital Reconstruction

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

Quality-of-Life Outcomes for Excision and Reconstruction of Periocular Nonmelanoma Skin Cancer

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