Older patients with basal cell or squamous cell carcinoma benefit from Mohs Surgery

June 2022 Science Nalinee Pandey

A new study reports plausible benefits of Mohs surgery in older patients with non-melanoma skin cancer. These findings were recently published in the journal JAMA Dermatology.

Mohs is a precision surgery to limit the unnecessary removal of healthy tissue around cancer. However, many investigators have raised concerns regarding this procedure on older patients with basal cell carcinoma or squamous cell carcinoma, two relatively benign types of skin cancer. In this study, investigators have addressed this issue and evaluated the effect of Mohs surgery on patients above 85 years.

Study Design

The multicentre prospective included 1181 patients older than 85 years referred for Mohs surgery at US private practice and academic centres.  Most patients were males (61.9%) aged 85-89 (57.9%) years. In addition, the researchers evaluated a list of 15 plausible reasons on which the doctors recommended surgery.

Results

Among all the patients, 91.3% of patients opted for Mohs surgery, while the remaining went to other alternatives. Most patients (68.5%) had tumours on the face, and those who underwent surgery were four times more likely to have high functional status than those without surgery. The most common reason for surgeons referring patients for surgery was the high cure rate (66.0% of cases), the patients’ functional status (57.0%), and/or the histology-based risk associated with the tumour (40.3%).

Conclusion

The investigators concluded that certain older patients may benefit from Mohs surgery.

Reference

Maisel-Campbell A, Lin KA, Ibrahim SA, et al. Nonmelanoma skin cancer in patients older than age 85 years presenting for Mohs surgery: a prospective, multicenter cohort study. JAMA Dermatol. Published online May 25, 2022. doi:10.1001/jamadermatol.2022.1733

X