Haisma Marjolijn S, Bras Linda, Aghdam Mehran Alizadeh, Terra Jorrit B, Plaat Boudewijn E C, Rácz Emöke, Halmos Gyorgy B
Department of Dermatology, University Medical Center Groningen (UMCG), 9713 GZ Groningen, The Netherlands. E-mail:
Acta Derm Venereol. 2020 Jun 18;100(13):adv00189. doi: 10.2340/00015555-3543.
There are straightforward guidelines for treatment of keratinocyte carcinoma (formerly known as non-melanoma skin cancer); however, there are no clear recommendations specifically for elderly patients. The aim of this review was to provide an overview of the current literature about the effect of patient characteristics, specifically life expectancy, frailty and comorbidity, on treatment decisions in elderly patients with keratinocyte carcinoma, by searching PubMed database. It was found that the literature is limited and based mostly on small retrospective studies. Therefore, it is difficult to give firm recommendations about how to treat elderly people who have keratinocyte carcinoma. A "one-size-fits-all" approach to this population is not sufficient: life expectancy and frailty need to be considered in the decision-making process regarding treatment for elderly people with keratinocyte carcinoma. Among the comorbidity scores, Adult-Comorbidity-Evaluation-27-index seems to have the best prognostic value. Prospective studies are needed to generate more individualized recommendations for this increasing and often vulnerable group.
对于角质形成细胞癌(以前称为非黑素瘤皮肤癌)有直接的治疗指南;然而,对于老年患者并没有明确的具体建议。本综述的目的是通过检索PubMed数据库,概述当前关于患者特征,特别是预期寿命、虚弱和合并症,对老年角质形成细胞癌患者治疗决策影响的文献。结果发现,相关文献有限,且大多基于小型回顾性研究。因此,很难就如何治疗患有角质形成细胞癌的老年人给出确切建议。对这一人群采用“一刀切”的方法是不够的:在为老年角质形成细胞癌患者制定治疗决策时,需要考虑预期寿命和虚弱程度。在合并症评分中,成人合并症评估27指数似乎具有最佳的预后价值。需要进行前瞻性研究,为这一不断增加且通常较为脆弱的群体制定更具个性化的建议。