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Functionality of Patients 75 Years and Older Undergoing Mohs Micrographic Surgery: A Multicenter Study
Christie G Regula1, Murad Alam, Ramona Behshad
1*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.
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.
Conclusion:
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.
