Is Mohs Surgery for Skin Cancer After Age 85 Worth It?

By Reuters Staff

May 31, 2022

NEW YORK (Reuters Health) - It's been suggested that Mohs surgery for non-melanoma skin cancer in patients with limited life expectancy may be associated with needless risk and discomfort. But a new study finds that untreated skin cancer in the elderly may be associated with functional loss, pain and disfigurement.

The research team studied 1,181 patients older than age 85 years who were referred for Mohs surgery. The vast majority (91.3%) had the surgery, with only 8.7% receiving an alternative treatment.

Patients receiving Mohs surgery were more likely to have tumors on the face (68.5% vs. 25.2%; P<0.001) and nearly four-fold more likely to have high functional status (57.0% vs. 15.5%; P<0.001).

The three most common reasons cited by surgeons for opting to proceed with Mohs surgery in patients age 85+ were patient desire for treatment with a high cure rate (66.0%), good or excellent patient functional status for age (57.0%), and high risk associated with the tumor based on histology (40.2%).

In a paper in JAMA Dermatology, Dr. Murad Alam with Northwestern University Feinberg School of Medicine in Chicago and colleagues say their study included a large number of geographically diverse centers and is one of the largest prospective cohorts of older people undergoing going skin cancer surgery.

"These findings suggest that timely surgical treatment may be appropriate in older patients given that their tumors may be aggressive, painful, disfiguring, and anxiety provoking," they write.

SOURCE: https://bit.ly/3MRvdS8 JAMA Dermatology, online May 25, 2022.

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