Background Patient-reported outcome measures provide essential data on treatment quality across diverse populations. The FACE-Q Skin Cancer Module was developed to assess outcomes specific to facial skin cancer patients. Longitudinal data characterizing outcome trajectories from surgery through early recovery remain limited.

Objective We tracked how patient outcomes change from preoperatively through three months after surgery using the FACE-Q Skin Cancer Module in a prospective cohort of 288 patients undergoing facial skin cancer surgery.

Methods Participants completed the module preoperatively and at 1 week and 3 months postoperatively. Five scales were evaluated: Appearance, Psychosocial Distress, Cancer Worry, Scars, and Adverse Effects. Friedman tests assessed overall change across timepoints; paired t-tests and Wilcoxon signed-rank tests evaluated pairwise comparisons.

Results Of 288 enrolled patients (mean age 68.6±11.9 years, 46.5% female), 252 (87.5%) and 220 (76.4%) completed 1-week and 3-month follow-up, respectively. Facial appearance declined at 1 week (55.6 to 52.0, p=0.005) and returned to baseline by 3 months (57.0, p=0.274). Psychosocial distress increased acutely (14.5 to 19.0, p<0.001) with partial recovery at 3 months (17.1, p=0.012). Cancer worry decreased substantially (Δ=−7.8, SRM=−0.54, p<0.001), and scar satisfaction improved from 1 week to 3 months (Δ=+9.4, SRM=0.54, p<0.001). Adverse effects showed the largest improvement (Δ=−12.8, SRM=−0.88, p<0.001). Women showed less improvement in facial appearance than men (Δ=−2.2 vs +4.9, p=0.022). Clinical meaningfulness was assessed using minimally important difference thresholds: 36.9% of patients achieved meaningful improvement in appearance, 39.6% remained stable, and 23.4% experienced meaningful deterioration.

Conclusions Short-term outcomes follow a predictable pattern, with acute perioperative worsening followed by recovery by 3 months for most patients.

The authors have declared no competing interest.

This study did not receive any funding.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Medical Ethics Review Committee of the Catharina Ziekenhuis, Eindhoven, The Netherlands, approved this study. All participants provided written informed consent.

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The data underlying this study were collected at Clinique Rebelle, Amsterdam. Requests may be directed to the corresponding author. Clinic information: https://www.cliniquerebelle.com

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