Evaluation of the effect of surgical treatment on quality of life with The Dermatology Life Quality Index (DLQI) in patients with facial nonmelanoma skin cancer

Skin Cancer
30/07/2020

Dermatol Ther. 2020 Jul 29:e14094. doi: 10.1111/dth.14094. Online ahead of print.

ABSTRACT

BACKGROUND: Skin cancers are the most common type of cancer. Nonmelanoma skin cancers (NMSC) are more common than melanoma. Although the mortality rate is low, cancer word can be frightening for patients. Surgery is the main treatment. As skin cancers are most commonly located on the face, undesirable cosmetic results can occur as a result of treatments or due to primary disease. Therefore the quality of life of patients could be affected.

AIMS: To determine the effect of surgical treatment on quality of life of the patients with facial NMSC using Dermatology Life Quality Index (DLQI) at baseline and 3 months after surgery. We aimed to see if there was any improvement in quality of life scores after surgery, and to identify factors affecting quality of life.

METHODS: A total of 255 patients; 174 basal cell carcinoma (BCC) (68.2%) and 81 squamous cell carcinoma (SCC) (31.8%) were included in our study. All participants completed DLQI at baseline and 3 months after surgery.

RESULTS: The mean total DLQI scores were 6.37±6.28 in patients with BCC, and 6.35±6.16 in patients with SCC. The mean total DLQI scores were 3.96±5.14 in patients with BCC (p<0.001), and 4.49±5.24 in patients with SCC (p<0.001) 3 months after surgery. In patients with primary skin cancer, all subscale scores and total DLQI scores were worse than the recurrent skin cancer group in both BCC and SCC at baseline. According to the treatment modalities, total DLQI scores and all subscales were worse in the graft group in BCC and SCC patients at baseline. Interestingly, the sex and the type of skin cancer did not affect quality of life, but tumor localization [(Auricula OR: 6.45 (95% CI: 1.28-37.47) and eyelid OR:0.20 (95% CI: 0.04-0.96)] treatment procedure [(Flap procedure OR: 7.90 (95% CI: 2.64-23.62) and graft procedure OR: 5.47 (95% CI: 1.60-18.71)] and, primary tumor OR:3.86 (95% CI: 1.01-14.78) were significant.

CONCLUSION: The quality of life of skin cancer patients was affected by tumor localization, treatment procedure, primary or recurrent tumor. The quality of life showed a significant improvement in patients with facial NMSC after surgical treatment. However, the type of NMSC seems to have no effect on quality of life. This article is protected by copyright. All rights reserved.