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van Winden MEC, Bronkhorst EM, Visch MB, et al. Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort. J Am Acad Dermatol. 2021;doi: 10.1016/j.jaad.2021.05.041.
van Winden, M. E. C., Bronkhorst, E. M., Visch, M. B., Krekels, G. A. M., van der Geer, S., Damen, G. W. J. A., Amir, A., Aben, K. K. H., Gerritsen, M. J. P., van de Kerkhof, P. C. M., de Jong, E. M. G. J., & Lubeek, S. F. K. (2021). Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort. Journal of the American Academy of Dermatology, . https://doi.org/10.1016/j.jaad.2021.05.041
van Winden, Marieke E C, et al. "Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort." Journal of the American Academy of Dermatology vol. (2021). doi: https://doi.org/10.1016/j.jaad.2021.05.041
van Winden MEC, Bronkhorst EM, Visch MB, Krekels GAM, van der Geer S, Damen GWJA, Amir A, Aben KKH, Gerritsen MJP, van de Kerkhof PCM, de Jong EMGJ, Lubeek SFK. Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort. J Am Acad Dermatol. 2021 Jun 01; doi: 10.1016/j.jaad.2021.05.041. Epub 2021 Jun 01. PMID: 34082036.
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J Am Acad Dermatol. 2021 Jun 01; doi: 10.1016/j.jaad.2021.05.041. Epub 2021 Jun 01.

Predictors of surgical treatment burden, outcomes, and overall survival in older adults with basal cell carcinoma: Results from the prospective, multicenter BATOA cohort.

Journal of the American Academy of Dermatology

Marieke E C van Winden, Ewald M Bronkhorst, M Birgitte Visch, Gertruud A M Krekels, Simone van der Geer, Godelieve W J A Damen, Avital Amir, Katja K H Aben, Marie-Jeanne J P Gerritsen, Peter C M van de Kerkhof, Elke M G J de Jong, Satish F K Lubeek

Affiliations

  1. Department of Dermatology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands. Electronic address: [email protected].
  2. Department of Biostatistics, Radboud University Medical Center, Nijmegen, the Netherlands.
  3. Department of Dermatology, Rijnstate Hospital, Arnhem, the Netherlands.
  4. Department of Dermatology, MohsA Clinic, Eindhoven, the Netherlands.
  5. Department of Dermatology, MohsA Clinic, Venray, the Netherlands.
  6. Department of Otorhinolaryngology/Facial Plastic Surgery, Nijmegen, the Netherlands.
  7. Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.
  8. Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.
  9. Department of Dermatology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

PMID: 34082036 DOI: 10.1016/j.jaad.2021.05.041

Abstract

BACKGROUND: Incorporating patient-related factors associated with treatment outcomes could improve personalized care in older patients with basal cell carcinoma (BCC).

OBJECTIVE: To evaluate and identify predictors of treatment burden, treatment outcomes, and overall survival in patients aged ≥70 years, surgically treated for BCC in the head and neck area.

METHODS: The data from the prospective, multicenter Basal Cell Carcinoma Treatment in Older Adults (BATOA) cohort study were extracted to evaluate the experienced treatment burden (visual analog scale, 0-10 cm; lower scores indicating higher treatment burden), treatment outcomes, and mortality.

RESULTS: A total of 539 patients were included (median age, 78 years). The patients experienced a low overall treatment burden (median, 8.6) and good cosmetic results. The predictors of higher treatment burden were instrumental activities of daily living (iADL) dependency, female sex, complications, larger tumor diameter, and polypharmacy. Thirty-five patients (6.5%) died (none of the deaths were due to BCC) within the follow-up period; the predictors of mortality were increasing comorbidity index and iADL dependency. No difference in these outcomes was seen between Mohs micrographic surgery and conventional excision after correction for covariates. Age was not significantly associated with any outcome.

LIMITATIONS: A selection bias may exist owing to the observational design.

CONCLUSION: BCC management decisions based on chronological age alone should be avoided, whereas more attention is recommended for patient-related factors. Based on these data, early BCC intervention is beneficial for robust and fit patients or those experiencing symptoms.

Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Keywords: Mohs micrographic surgery; aged; basal cell carcinoma; basal cell carcinoma recurrences; complications; conventional excision; cosmetic result; elderly; facial surgery; frailty; keratinocyte carcinoma; mortality; older adults; skin cancer; surgery; survival; traditional excision; treatment burden; treatment outcomes

Conflict of interest statement

Conflicts of interest Dr Lubeek has been a consultant and/or paid speaker for Leo Pharma and Sanofi Genzyme. All the financial compensations were paid to the independent research fund of the Departmen

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