title: Life expectancy after Mohs micrographic surgery in patients aged 90 years and older.
abstract: BACKGROUND
  The population of people aged 90 years and older is expected to more than triple by 2050. The incidence of skin cancers is increasing.
  
  
  OBJECTIVE
  We sought to determine whether treatment of patients aged 90 years and older with skin cancer by Mohs micrographic surgery (MMS) changed their survival.
  
  
  METHODS
  A group of 214 patients aged 90 years and older who underwent MMS from July 1997 to May 2006 was identified. Patient gender, age, tumor type, size, site, defect size, number of MMS stages, and surgical repair were recorded. Comorbid medical conditions were assessed using the Charlson index. Actual survival was compared with expected length of survival using life tables. Data were analyzed by the Kaplan-Meier method with log rank significance tests.
  
  
  RESULTS
  Average patient age was 92.3 years. All patients tolerated the procedures well with no deaths within 1 month after surgery. Median survival after surgery was 36.9 months. Tumor characteristics, defect size, number of surgical stages, and closure type did not affect survival. There was no significant difference in survival based on comorbidities according to Charlson scores. Instantaneous mortality hazard was highest 2 to 3 years after surgery.
  
  
  CONCLUSIONS
  Specific causes of death were not accessible.
  
  
  CONCLUSIONS
  This growing section of the population may safely undergo MMS.
authors.affiliation: Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Delaney
authors.forename: Ikue
authors.initials: I
authors.lastname: Shimizu
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Goldberg
authors.forename: Deborah F
authors.initials: DF
authors.lastname: MacFarlane
mesh_terms: D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D015580:Mohs Surgery / Q000401:mortality*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*