Older patients who undergo Mohs surgery for nonmelanoma skin cancer often have high functional status, according to a study published online May 25 in JAMA Dermatology .

Amanda Maisel-Campbell, M.D., from the Feinberg School of Medicine in Chicago, and colleagues examined patient- and tumor-specific indications considered by clinicians for treatment of nonmelanoma skin cancer in older adults aged 85 years or older presenting for skin cancer surgery and referred for Mohs surgery. Data were included for 1,181 patients referred for Mohs surgery treated at 22 sites.

The researchers found that 91.3 and 8.7 percent of the patients were treated by Mohs surgery and received alternative treatment, respectively. Patients receiving Mohs surgery were more likely to have tumors on the face (68.5 versus 25.2 percent) and to have high functional status (57.0 versus 15.5 percent). There were 15 possible reasons identified for selecting Mohs surgery; the most common reasons provided by surgeons for opting to proceed with Mohs surgery were patient desire for treatment with a high cure rate, good or excellent patient functional status for age, and higher risk associated with the tumor based on histology (66.0, 57.0, and 40.2 percent, respectively).

"These findings suggest that patient functional status is associated with decisions on how cancers are treated, given that high-functioning status was among the most common reasons for surgery in patients older than age 85 years," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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