Hospital de la Princesa, Madrid, Spain.
Hospital Universitario Quirón Salud Madrid, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2018 Jan;32(1):108-112. doi: 10.1111/jdv.14586. Epub 2017 Oct 5.
The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery (MMS). The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single-centre studies without a comparison group.
To compare the characteristics of patients, tumours, MMS and 1-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery.
Data was analysed from REGESMOHS, a prospective cohort study of patients treated with MMS. The participating centres were 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patient, tumour and surgery were recorded. Follow-up data were collected from two visits; the first within 1 month postsurgery and the second within the first year.
From July 2013 to October 2016, 2575 patients that underwent MMS were included in the registry. Of them, 1942 (75.4%) were aged <80 years and 633 (24.6%) were ≥80 years old. In the elderly, the tumour size was significantly higher with a higher proportion of squamous cell carcinoma. Regarding surgery, elderly more commonly had tumours with deeper invasion and required a higher number of Mohs surgery stages, leaving larger defects and requiring more time in the operating room. Despite this, the incidence of postoperative complications was the same in both groups (7%) and there were no significant differences in proportion of relapses in the first-year follow-up.
The risk of short-term complications and relapses were similar in elderly and younger groups. MMS is a safe procedure in the elderly.
老年人口不断增加，越来越多的老年患者接受 Mohs 显微外科手术（MMS）。少数研究老年人 MMS 的出版物得出结论，该手术是安全的；然而，这些都是单中心研究，没有对照组。
比较 80 岁以下和 80 岁以上患者的患者特征、肿瘤、MMS 和 1 年随访情况。
对 REGESMOHS 进行数据分析，这是一项对接受 MMS 治疗的患者进行的前瞻性队列研究。参与的中心是 19 家西班牙医院，每周至少进行一次 MMS。记录患者、肿瘤和手术的特征数据。随访数据来自两次就诊，第一次是手术后 1 个月内，第二次是手术后 1 年内。
2013 年 7 月至 2016 年 10 月，登记了 2575 例接受 MMS 的患者。其中，1942 例（75.4%）年龄<80 岁，633 例（24.6%）年龄≥80 岁。在老年人中，肿瘤大小明显更大，鳞状细胞癌的比例更高。关于手术，老年人的肿瘤浸润深度通常更高，需要更多的 Mohs 手术阶段，留下更大的缺陷，需要在手术室花费更多的时间。尽管如此，两组术后并发症的发生率相同（7%），在 1 年随访中复发比例也没有显著差异。
短期并发症和复发的风险在老年组和年轻组相似。MMS 在老年人中是一种安全的手术。
