Clinical outcomes of the management of basal cell carcinomas in individuals aged 90 years and over: a retrospective cohort study.

Autor:	Nicholls I; Norfolk and Norwich University Hospital, Norwich, UK., Moncrieff M; Norfolk and Norwich University Hospital, Norwich, UK., Patel M; Norfolk and Norwich University Hospital, Norwich, UK., Nobes J; Norfolk and Norwich University Hospital, Norwich, UK., Garioch J; Norfolk and Norwich University Hospital, Norwich, UK.
Jazyk:	angličtina
Zdroj:	Clinical and experimental dermatology [Clin Exp Dermatol] 2024 Dec 23; Vol. 50 (1), pp. 120-124.
DOI:	10.1093/ced/llae344
Abstrakt:	Background: A retrospective cohort study was undertaken to examine the management of basal cell carcinoma (BCC) in older patients. Objectives: The aim of this study was to identify subgroups where intervention could be minimized, based on frailty and trends in survival. Methods: All patients aged ≥ 90 years with histologically confirmed BCC during 2017 and 2018 were included within the study (n = 319). Results: Age was the most significant predictor of survival [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.04-1.17; P = 0.001]. Maximum threshold analysis identified 93 years as the significant age cutpoint. Median survival was 40 months for patients aged ≤ 93 years and 28 months for those aged > 93 years (P = 0.002). Patients with dementia had a worse survival than those without (median survival 25 months vs. 35 months, respectively; HR 1.92, 95% CI 1.18-3.13; P = 0.009). There was a statistically significant difference in survival for patients who received treatment for their BCC (n = 294) compared with the untreated cohort (n = 25) (median survival 34 months vs. 21 months, respectively; HR 0.54, 95% CI 0.34-0.85; P = 0.007). All other comorbidities examined had no influence on survival. Conclusions: This study provides evidence in support of active treatment of BCC in individuals aged ≥ 90 years, seen in secondary care. Conservative options may be preferable in patients with dementia or those > 93 years old. Competing Interests: Conflicts of interest The authors declare they have no conflicts of interest. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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