title: Factors associated with postoperative complications in elderly patients with skin cancer: A retrospective study of 241 patients.
abstract: OBJECTIVE
  The increasing frequency of skin tumors and longer life expectancy of the general population are likely to increase the frequency of dermatological surgery among elderly patients. The purpose of this study is to assess the rate of postoperative complications related to dermatological surgery in elderly patients and highlight the factors associated with these complications.
  
  
  METHODS
  We conducted a retrospective monocentric study of patients aged >75 years who presented at our multidisciplinary consultation specialized for skin tumors from January 2008 to December 2010. The clinical characteristics, demographic information, and cancer history of these patients were analyzed. Postoperative complications (dehiscence, infection, hematomas, and other sequelae) were identified to establish the postoperative complication rate and determine risk factors.
  
  
  RESULTS
  We included 241 patients. Basal cell carcinoma, squamous cell carcinoma, and melanoma accounted for 46%, 25%, and 28% of tumors, respectively. Skin carcinomas were mainly located on the face (93% of basal cell carcinomas and 72% of squamous cell carcinomas), and melanomas were mainly located on the limbs (50%). The average number of comorbidities was 3.0±1.5. The average postoperative complication rate was 20%. Multivariate analysis identified three independent risk factors: male gender (p<0.033), histological type (squamous cell carcinoma and melanoma) (p<0.008), and insufficient surgical resection (p<0.004).
  
  
  CONCLUSIONS
  This study highlighted a high rate of postoperative complications in this elderly population. Three significant postoperative risk factors were identified. They may be used to assess a patient's operational risk as well as geriatric assessment tools.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France. Electronic address: jbouhassira@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bouhassira
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Bosc
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
authors.forename: Lipa
authors.initials: L
authors.lastname: Greta
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hersant
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Niddam
authors.affiliation: UPEC, University Paris East Creteil, Val de Marne, France; Department of Dermatology, Creteil, France; French Satellite of the Cochrane Skin Group, Creteil, France; Centre d'investigation Clinique Inserm 006, EA 439, France.
authors.forename: Ouidad
authors.initials: O
authors.lastname: Zehou
authors.affiliation: UPEC, University Paris East Creteil, Val de Marne, France; Unit of Clinical Research, Creteil, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.affiliation: UPEC, University Paris East Creteil, Val de Marne, France; Department of Dermatology, Creteil, France; French Satellite of the Cochrane Skin Group, Creteil, France; Centre d'investigation Clinique Inserm 006, EA 439, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Wolkenstein
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Meningaud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015897:Comorbidity; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects*; D005121:Extremities; D005145:Face; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008545:Melanoma / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000601:surgery*
keywords: Elderly; Postoperative complications; Skin cancer