Background

Changes in patient perceptions of quality of life (QOL) after Mohs micrographic surgery (MMS) may benefit from different counseling or treatment.

Objective

To measure QOL before and after MMS and to identify risk factors associated with impaired QOL.

Methods

Prospective observational study of 727 patients with skin cancer who self-reported QOL via the Skin Cancer Index immediately before and at 1 to 2 weeks and 3 months after MMS.

Results

QOL fluctuated after MMS. At 1 to 2 weeks after surgery, overall QOL remained unchanged compared with before MMS. Patients reported reduced anxiety about skin cancer but had increased distress about social interactions and physical appearance. At 3 months after surgery, patients reported an overall improvement in QOL compared with before MMS (P = .0007). Age younger than 65 years (P = .0001), female sex (P = .0001), and tobacco use (P = .03) were associated with lower QOL scores at all assessment points.

Limitations

Single-site observational study. Significant loss to follow-up at both time points after MMS.

Conclusion

Patients with skin cancer had persistent concerns about social interactions and physical appearance 1 to 2 weeks after MMS, but all aspects of their QOL improved by 3 months after surgery. Patients who underwent MMS that were younger than 65 years, were female, or smoked were at increased risk for longitudinally impaired QOL.

中文翻译：

---

莫氏显微手术前后患者生活质量的波动：患者体验的纵向评估

背景

莫氏显微手术 (MMS) 后患者对生活质量 (QOL) 感知的变化可能会受益于不同的咨询或治疗。

客观的

测量 MMS 前后的 QOL 并确定与 QOL 受损相关的风险因素。

方法

对 727 名皮肤癌患者的前瞻性观察研究，这些患者在 MMS 之前和之后 1 至 2 周和 3 个月通过皮肤癌指数自我报告 QOL。

结果

MMS后QOL波动。术后 1～2 周，总体 QOL 与 MMS 前相比保持不变。患者报告说对皮肤癌的焦虑减少了，但对社交互动和外貌的困扰增加了。手术后 3 个月，患者报告的 QOL 与 MMS 前相比总体有所改善 ( P  = .0007)。 在所有评估点 ，年龄小于 65 岁 ( P = .0001)、女性 ( P  = .0001) 和烟草使用 ( P = .03) 与较低的 QOL 得分相关。

限制

单点观察性研究。MMS 后的两个时间点均显着失访。

结论

皮肤癌患者在 MMS 后 1 至 2 周对社交互动和外貌持续存在担忧，但在手术后 3 个月，他们的生活质量的各个方面都有所改善。接受 MMS 的年龄小于 65 岁、女性或吸烟的患者发生 QOL 纵向受损的风险增加。