An assessment of the suitability of Mohs micrographic surgery in patients aged 90 years and older.
BACKGROUND
One option for the treatment of cutaneous tumors in the very elderly has been simple observation. However, the combination of an increasing elderly population and a concomitant high incidence of skin cancer will make this problem more common.


OBJECTIVE
To assess the suitability of Mohs micrographic surgery as a treatment modality for skin cancer in the 90 years and older age group.


METHODS
A group of patients who underwent Mohs surgery from January 1988 to August 1996 aged 90 years and older was identified, and tumor type, site, comorbid medical conditions, medications, and surgical complications were recorded.


RESULTS
A total of 106 basal cell carcinomas (BCCs), 33 squamous cell carcinomas (SSC), six melanomas, and one basosquamous carcinoma were resected from 115 patients with an average age of 92.4 years. The overall ratio of BCC/SCC was 3.2 BCCs occurred most commonly on the face; SCCs were found more frequently on the cheeks. Patients had an average of 1.9 comorbid medical conditions and took an average of 2.3 regular medications. One complication occurred.


CONCLUSIONS
Mohs surgery is a safe and effective therapy for those over 90 years of age.
MacFarlane
D F
DF
Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.
Pustelny
B L
BL
Goldberg
L H
LH
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002281:Carcinoma, Basosquamous / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002610:Cheek / Q000601:surgery; D004194:Disease; D004358:Drug Therapy; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery; D015580:Mohs Surgery / Q000009:adverse effects; D012189:Retrospective Studies; D012449:Safety; D012737:Sex Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*