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Assessment of Functionality in Elderly Patients When Determining Appropriate Treatment for Nonmelanoma Skin Cancers

Michael A Renzi1, Matthew Belcher2, Bruce Brod3

  • 1Division of Dermatology, Cooper Medical School of Rowan University, Camden, New Jersey.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
|July 30, 2019
PubMed
Abstract

Insights

Patient functionality impacts nonmelanoma skin cancer (NMSC) treatment selection in elderly patients. Dermatologists opt for less invasive methods for those with lower functional status, even if surgery is indicated.

Area of Science:

  • Dermatology
  • Geriatric Medicine
  • Surgical Oncology

Background:

  • Treatment of nonmelanoma skin cancer (NMSC) in the elderly presents challenges.
  • Mohs micrographic surgery (MMS) is effective but not universally applicable.
  • Appropriate use criteria (AUC) guide surgical decisions.

Purpose of the Study:

  • To assess the role of patient functionality in NMSC treatment selection for elderly patients.
  • To utilize the Karnofsky Performance Status (KPS) scale for functional assessment.
  • To determine if functional status influences the choice of NMSC treatment modality.

Main Methods:

  • Included patients aged 75+ with NMSC meeting AUC for MMS.
  • Assessed patient functionality using the KPS scale.
  • Recorded NMSC treatment modality post-biopsy confirmation.

Main Results:

  • A cohort of 203 elderly patients was analyzed.
  • A statistically significant difference in surgical treatment utilization was observed between high and low functionality groups (p = .03).

Conclusions:

  • Patient functionality is a key consideration in NMSC treatment planning for older adults.
  • Dermatologists adjust treatment strategies based on patient functional status.
  • Less invasive treatments are favored for elderly patients with poorer functional status, irrespective of AUC.

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