This article is more than 5 years old. Information may no longer be current.

Older patients undergoing Mohs micrographic surgery are highly functioning

Most patients aged 75 years and older undergoing Mohs micrographic surgery were found to be highly functioning, according to research published in Dermatologic Surgery.

Researchers studied 291 patients aged 75 years and older (mean age, 82.1 years; 180 men) who were undergoing Mohs micrographic surgery at eight geographically diverse U.S. locations. Physicians used Karnofsky Performance Status (KPS) scale to score patients and conducted a five-question questionnaire to categorize symptoms and skin cancer impact.

Patient and tumor characteristics, including age, sex, tumor type, tumor location and tumor size, were noted.

Patients had 168 basal cell carcinomas, 119 squamous cell carcinomas and four basosquamous cell carcinomas, with the average tumor size of 1.3 x 1 cm. The nose was the most common tumor location site, followed by the cheek and forehead.

Patients had an average KPS score of 90.1 (range, 40-100), with 92.8% of patients having a KPS score of at least 70. Patients who had a KPS score of less than 70 were more likely to be older (P = .0028) and have larger tumors (P = .033 and P = .0147).

“The vast majority of our patients undergoing Mohs surgery for nonmelanoma skin cancer were high functioning. … 89.7% [of patients] had a KPS score greater than 80, indicating that these patients can carry on normal activity with effort with some signs or symptoms of disease,” the researchers wrote.

“What we are suggesting is that patients should not be refused or discouraged from a treatment based on comorbidities alone — the patient as a whole must be taken into account,” the researchers concluded. “As the use of Mohs surgery continues to be scrutinized by patients, press, insurance carriers and our peers, we must continue to show our value to the health care system and our diligence in appropriate use, both for appropriate tumors and appropriate patients. Quantifying a patient’s functional status is just one data point by which we can do so.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.