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Graft or flap repair linked to high frequency of symptoms after skin cancer surgery

Patients with skin cancer who undergo graft or flap repair reported the most symptoms and those undergoing surgery on the lip reported more long-term symptoms, which may have a greater effect on quality of life, compared with surgery in other areas, according to a study.

“While patients often experience pain in the short-term postoperative period, milder symptoms such as numbness, sensitivity and tightness are more common in the long term; the face is the most pressure-sensitive area of the body, which may contribute to these findings,” Erica H. Lee, MD, of the dermatology department at Memorial Sloan Kettering Cancer Center, and colleagues wrote.

The cross-sectional study included patients aged at least 21 years who underwent skin cancer surgery from March 2016 to March 2018. The FACE-Q Skin Cancer Adverse Effects Checklist was utilized to determine postoperative symptoms of pain, discomfort, sensitivity, numbness, tingling, tightness, itchiness, swelling, bruising and difficulty with facial movements.

Of 1,049 eligible patients, 396 completed the questionnaire (37.8% response rate).

The researchers categorized responses based on time between surgery and survey completion: less than 6 months (average, 15.7 ± 8 weeks), 6 months to less than 1 year (average, 38 ± 8.3 weeks) and at least 1 year (average, 84.7 ± 23.1 weeks).

The average age of survey responders was 65.1 years (55.2% men).

The frequency of postoperative symptoms was low overall, with a range of 2.3% to 43.4%.

The frequency of sensitivity, numbness and tightness was highest less than 6 months and at least 1 year after surgery.

Flap or graft repair was associated with the highest incidence of symptoms at least 1 year after surgery, with numbness, tingling, tightness and itchiness most often reported.

Anatomically, the lip surgery site had the highest frequency of symptoms at least 1 year after surgery, with numbness, tingling and difficulty with facial movements most often reported.

Milder symptoms are common in the long term for patients undergoing cutaneous oncologic surgery.

The limitations of the study include a study population composed of mainly white patients, a cross-sectional design and the possibility of response-bias. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures. The FACE-Q Skin Cancer Module is owned by Memorial Sloan Kettering Cancer Center.