Short-Term Patient-Reported Outcomes After Facial Skin Cancer Surgery: A Prospective Longitudinal Study Using the FACE-Q Skin Cancer Module

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 (delta=-7.8, SRM=-0.54, p<0.001), and scar satisfaction improved from 1 week to 3 months (delta=+9.4, SRM=0.54, p<0.001). Adverse effects showed the largest improvement (delta=-12.8, SRM=-0.88, p<0.001). Women showed less improvement in facial appearance than men (delta=-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.