Functionality of Patients 75 Years and Older Undergoing Mohs Micrographic Surgery: A Multicenter Study.
BACKGROUND
Mohs surgery is indisputably a highly effective treatment for nonmelanoma skin cancers. In the current health care environment, physicians are challenged to provide high quality, efficacious care in a manner that is mindful of the patient's general health and well-being. We have used a functional assessment to evaluate older patients who present for Mohs surgery.


OBJECTIVE
The purpose of this study is to categorize the functional status, using the Karnofsky Performance Status (KPS) Scale, of patients 75 years and older undergoing Mohs surgery of a nonmelanoma skin cancer and to identify distinguishing characteristics of lower functioning patients.


METHODS
Patients 75 years and older undergoing Mohs surgery for nonmelanoma skin cancer at 8 separate geographically diverse sites were included. Patient and tumor characteristics were recorded. Physicians scored subjects on the KPS scale and administered a questionnaire to categorize the symptoms and impact of their skin cancer.


RESULTS
A total of 291 subjects completed the study. The average KPS score was 90.1. 93.1% of our subjects had a KPS score of ≥70. Subjects with a KPS score <70 were more likely to be older with larger symptomatic tumors.


CONCLUSIONS
The vast majority of patients 75 years and older undergoing Mohs surgery are highly functioning. Lower functioning patients are older with larger symptomatic tumors that negatively impact their lives.
*Vujevich Dermatology Associates, Pittsburgh, Pennsylvania; †Department of Dermatology, Northwestern University, Chicago, Illinois; ‡Department of Dermatology, St. Louis University, St. Louis, Missouri; §The Dermatology Group, West Orange, New Jersey; ‖Laser and Skin Surgery Center of Indiana, Carmel, Indiana; ¶Surgical Dermatology Group, Birmingham, Alabama; #Dermatology and Skin Surgery Center of Princeton, Princeton, New Jersey; **Dermatologic Surgery Specialists, PC, Macon, Georgia; ††Mercer Medical School, Macon, Georgia; ‡‡Department of Dermatology, University of California, Los Angeles, Los Angeles, California; §§Division of Dermatology, Cooper University Hospital, Marlton, New Jersey.
Christie G
CG
Regula
Murad
M
Alam
Ramona
R
Behshad
Marc
M
Glashofer
C William
CW
Hanke
Christopher
C
Harmon
Ryan
R
Johnson
David
D
Kent
Patrick
P
Lee
Naomi
N
Lawrence
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D015580:Mohs Surgery; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000601:surgery*