Surgery discretionary for elderly NMSC patients

Elderly patients with nonfatal skin cancers may not benefit from surgery, according to recent findings.

The study, led by researchers at the University of California, San Francisco, addressed the current standard of care in the United States for nonmelanoma skin cancers (NMSC). The researchers included nearly 1,400 patients who were diagnosed with NMSC. About 25 percent were considered to have limited life expectancy because they were at least 85 years old at time of diagnosis or presented with multiple comorbidities. The patients were followed for a median of nine years following no treatment, destruction or either elliptical excision or Mohs surgery, according to the study abstract.

Most of the NMSCs (69 percent) were treated surgically, regardless of the patient’s life expectancy or tumor characteristics. Although serious complications were rare, about 20 percent of patients with limited life expectancy reported a complication from their skin cancer treatment.

Nearly half (43 percent) of the patients with limited life expectancy died within five years; however, none of them died from NMSC, according to the abstract.

“Our study provides useful evidence for clinicians facing a treatment choice dilemma with their patients - it focuses on a cancer whose natural history is generally benign, where treatment itself may be discretionary,” senior author Mary-Margaret Chren, M.D., dermatology professor, UCSF School of Medicine, said in a news release.

The study was published online April 29 in JAMA Internal Medicine.