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Should Basal Cell Carcinoma Management Be Based on Age?

Age was not associated with any outcome among patients aged 70 years and older with basal cell carcinoma

By Dermsquared Editorial Team | April 27, 2022

For patients aged 70 years or older with basal cell carcinoma (BCC), the overall treatment burden is low and cosmetic results are good, according to a study published in the May issue of the Journal of the American Academy of Dermatology .

Marieke E.C. van Winden, M.D., from the Radboud Institute for Health Sciences in Nijmegen, Netherlands, and colleagues examined and identified predictors of treatment burden (visual analog scale, 0 to 10 cm; lower scores indicating higher treatment burden), treatment outcomes, and overall survival in patients aged 70 years or older who underwent surgical treatment for BCC in the head and neck area. Data were included for 539 patients with a median age of 78 years.

The researchers found that the overall treatment burden was low (median, 8.6) and cosmetic results were good. Instrumental activities of daily living (iADL) dependency, female sex, complications, larger tumor diameter, and polypharmacy were predictors of higher treatment burden. Within the follow-up period, 35 patients (6.5 percent) died; none of the deaths were attributed to BCC. Increasing comorbidity index and iADL dependency were predictors of mortality. After adjustment for covariates, there were no differences seen in these outcomes between Mohs micrographic surgery and conventional excision. There was no significant association observed for age with any outcome.

"BCC management decisions merely based on age as the sole patient-related factor should be avoided, as chronological age showed no significant association with treatment burden, complications, cosmetic results, and overall mortality," the authors write. "Moreover, using advanced age as an exclusion criterion could result in a delay in adequate medical interference."

One author disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text


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