75岁及以上患者接受莫氏显微外科手术的功能：一项多中心研究。

Functionality of Patients 75 Years and Older Undergoing Mohs Micrographic Surgery: A Multicenter Study.

作者信息

Regula Christie G, Alam Murad, Behshad Ramona, Glashofer Marc, Hanke C William, Harmon Christopher, Johnson Ryan, Kent David, Lee Patrick, Lawrence Naomi

机构信息

*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.

出版信息

Dermatol Surg. 2017 Jul;43(7):904-910. doi: 10.1097/DSS.0000000000001111.

DOI:10.1097/DSS.0000000000001111

PMID:28328703

Abstract

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.

摘要