Exploring Patients' Perceptions of One-step Surgery for Primary Cutaneous Melanoma: A Qualitative Study

Acta Derm Venereol. 2024 Sep 24:104:adv40064. doi: 10.2340/actadv.v104.40064.

Abstract

High-frequency ultrasonography (> 20 MHz) has allowed for preoperative measurement of melanoma thickness and thus a one-step surgery strategy. The potential benefits of one-step surgery to patients remain unexplored. From June 2022 to August 2023, 2 dermatologists conducted semi-structured individual interviews with patients who had undergone HFUS examination allowing the choice for one-step surgery (group A) and with patients who had had standard two-step surgery (group B). Analysis of interviews with 21 patients (age range 31-81 years) revealed 5 main themes: (a) understanding the diagnosis, highlighting the significance of clear and comprehensive medical explanations; (b) personal factors considered in treatment decisions, including preferences for minimizing surgical procedures; (c) making choices, bearing responsibility, thus showcasing different levels of patient involvement in decision-making; (d) high- frequency ultrasonography reassurance emphasizing the role of medical reassurance, and (e) patient satisfaction, discussing surgical outcomes and the decision-making process. The majority of participants expressed a clear preference for one-step surgery, perceived as a pragmatic and fast surgical strategy while minimizing interventions. In conclusion, the results emphasize the importance of patient-centred care. These insights can guide improved preoperative consultations and enhance shared decision-making between healthcare professionals and patients regarding melanoma treatment strategies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Interviews as Topic
  • Male
  • Melanoma* / psychology
  • Melanoma* / surgery
  • Middle Aged
  • Patient Participation
  • Patient Preference*
  • Patient Satisfaction*
  • Qualitative Research*
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / psychology
  • Skin Neoplasms* / surgery
  • Ultrasonography