Patients aged older than 85 years can safely undergo Mohs micrographic surgery to remove non-melanoma skin cancer and still have years of good quality of life, researchers reported here at the 75th Annual Meeting of the American Academy of Dermatology (AAD).
A group of patients who were aged at least 85 years when they underwent Mohs surgery lived an average of 6.2 years after undergoing the procedure, reported Emma Rogers, Robert Wood Johnson Medical School, Piscataway, New Jersey.
At her oral poster presentation on March 4, Rogers said that the 373 patients who underwent Mohs surgery at Memorial Sloan-Kettering, New York, New York, from July 1999 to December 2014 had a mean age of 87.5 years, and on average the patients survived to be 93.7 years.
"You can't just withhold treatment based on a patient's age," Rogers said. "Age alone is not appropriate to determine if someone is eligible for surgery. Obviously there are many factors that should determine whether a patient is suitable for surgery, but this study shows that age by itself should not be a cut-off."
Rogers did note that there is a controversy over whether one should treat this older patient population.
Non-melanoma skin cancers are rarely fatal, but without treatment they can grow larger, bleed and become symptomatic, she said. Hence, if the cancers appear on the face of head Mohs micrographic surgery is performed.
In the patients that were studied retrospectively, 43.6% underwent the 2-stage surgical procedure, 21.2% required 3 surgeries, and 6.7% had 4 or more surgeries. The mean size of the lesions was 0.9 cm in length and 0.8 cm in width.
Rogers acknowledged that her study results are limited by not having a control group.
Co-morbidity did not make a difference in patient outcome. The 8-year survival among patients who had a 0-1 score on the Adult Comorbidity Evaluation-27 (ACE-27) was 40% compared with an 8-year survival of 15% for patients with an ACE-27 score of 2 to 3.
[Presentation title: Life Expectancy After Mohs Micrographic Surgery. Abstract 4997]