Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
J Am Acad Dermatol. 2013 Feb;68(2):296-300. doi: 10.1016/j.jaad.2012.10.016. Epub 2012 Nov 27.
The population of people aged 90 years and older is expected to more than triple by 2050. The incidence of skin cancers is increasing.
We sought to determine whether treatment of patients aged 90 years and older with skin cancer by Mohs micrographic surgery (MMS) changed their survival.
A group of 214 patients aged 90 years and older who underwent MMS from July 1997 to May 2006 was identified. Patient gender, age, tumor type, size, site, defect size, number of MMS stages, and surgical repair were recorded. Comorbid medical conditions were assessed using the Charlson index. Actual survival was compared with expected length of survival using life tables. Data were analyzed by the Kaplan-Meier method with log rank significance tests.
Average patient age was 92.3 years. All patients tolerated the procedures well with no deaths within 1 month after surgery. Median survival after surgery was 36.9 months. Tumor characteristics, defect size, number of surgical stages, and closure type did not affect survival. There was no significant difference in survival based on comorbidities according to Charlson scores. Instantaneous mortality hazard was highest 2 to 3 years after surgery.
Specific causes of death were not accessible.
This growing section of the population may safely undergo MMS.
预计到 2050 年，90 岁及以上人口将增加两倍以上。皮肤癌的发病率正在上升。
我们旨在确定对 90 岁及以上皮肤癌患者进行 Mohs 显微外科手术（MMS）治疗是否会改变他们的生存情况。
确定了一组 214 名 90 岁及以上接受 MMS 的患者，这些患者在 1997 年 7 月至 2006 年 5 月期间接受了 MMS。记录了患者的性别、年龄、肿瘤类型、大小、部位、缺陷大小、MMS 阶段数量和手术修复情况。使用 Charlson 指数评估合并症的医疗状况。使用生命表比较实际生存情况和预期生存时间。通过 Kaplan-Meier 方法和对数秩检验进行数据分析。
患者的平均年龄为 92.3 岁。所有患者均能很好地耐受手术，术后 1 个月内无死亡。术后中位生存时间为 36.9 个月。肿瘤特征、缺陷大小、手术阶段数量和闭合类型均不影响生存。根据 Charlson 评分，合并症对生存的影响无显著差异。术后 2 至 3 年内瞬时死亡率最高。
无法获得具体的死亡原因。
这一不断增长的人群可以安全地接受 MMS。
