Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer
Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the popu...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Rogers, Emma M. [verfasserIn] Connolly, Karen L. [verfasserIn] Nehal, Kishwer S. [verfasserIn] Dusza, Stephen W. [verfasserIn] Rossi, Anthony M. [verfasserIn] Lee, Erica [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Journal of the American Academy of Dermatology - American Academy of Dermatology ; ID: gnd/1053786-7, Amsterdam [u.a.] : Elsevier, 1979, 78, Seite 1119-1124 |
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| Übergeordnetes Werk: |
volume:78 ; pages:1119-1124 |
| DOI / URN: |
10.1016/j.jaad.2017.12.048 |
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| Katalog-ID: |
ELV002579545 |
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| 245 | 1 | 0 | |a Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
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| 520 | |a Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. | ||
| 650 | 4 | |a comorbidity | |
| 650 | 4 | |a elderly | |
| 650 | 4 | |a limited life expectancy | |
| 650 | 4 | |a NMSC | |
| 650 | 4 | |a Mohs micrographic surgery | |
| 650 | 4 | |a skin cancer | |
| 700 | 1 | |a Connolly, Karen L. |e verfasserin |4 aut | |
| 700 | 1 | |a Nehal, Kishwer S. |e verfasserin |4 aut | |
| 700 | 1 | |a Dusza, Stephen W. |e verfasserin |4 aut | |
| 700 | 1 | |a Rossi, Anthony M. |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Erica |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |a American Academy of Dermatology ; ID: gnd/1053786-7 |t Journal of the American Academy of Dermatology |d Amsterdam [u.a.] : Elsevier, 1979 |g 78, Seite 1119-1124 |h Online-Ressource |w (DE-627)320411745 |w (DE-600)2001404-1 |w (DE-576)094426791 |x 1097-6787 |7 nnns |
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2018 |
| allfields |
10.1016/j.jaad.2017.12.048 doi (DE-627)ELV002579545 (ELSEVIER)S0190-9622(17)32888-8 DE-627 ger DE-627 rda eng 610 DE-600 44.93 bkl Rogers, Emma M. verfasserin aut Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer Connolly, Karen L. verfasserin aut Nehal, Kishwer S. verfasserin aut Dusza, Stephen W. verfasserin aut Rossi, Anthony M. verfasserin aut Lee, Erica verfasserin aut Enthalten in American Academy of Dermatology ; ID: gnd/1053786-7 Journal of the American Academy of Dermatology Amsterdam [u.a.] : Elsevier, 1979 78, Seite 1119-1124 Online-Ressource (DE-627)320411745 (DE-600)2001404-1 (DE-576)094426791 1097-6787 nnns volume:78 pages:1119-1124 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.93 Dermatologie AR 78 1119-1124 |
| spelling |
10.1016/j.jaad.2017.12.048 doi (DE-627)ELV002579545 (ELSEVIER)S0190-9622(17)32888-8 DE-627 ger DE-627 rda eng 610 DE-600 44.93 bkl Rogers, Emma M. verfasserin aut Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer Connolly, Karen L. verfasserin aut Nehal, Kishwer S. verfasserin aut Dusza, Stephen W. verfasserin aut Rossi, Anthony M. verfasserin aut Lee, Erica verfasserin aut Enthalten in American Academy of Dermatology ; ID: gnd/1053786-7 Journal of the American Academy of Dermatology Amsterdam [u.a.] : Elsevier, 1979 78, Seite 1119-1124 Online-Ressource (DE-627)320411745 (DE-600)2001404-1 (DE-576)094426791 1097-6787 nnns volume:78 pages:1119-1124 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.93 Dermatologie AR 78 1119-1124 |
| allfields_unstemmed |
10.1016/j.jaad.2017.12.048 doi (DE-627)ELV002579545 (ELSEVIER)S0190-9622(17)32888-8 DE-627 ger DE-627 rda eng 610 DE-600 44.93 bkl Rogers, Emma M. verfasserin aut Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer Connolly, Karen L. verfasserin aut Nehal, Kishwer S. verfasserin aut Dusza, Stephen W. verfasserin aut Rossi, Anthony M. verfasserin aut Lee, Erica verfasserin aut Enthalten in American Academy of Dermatology ; ID: gnd/1053786-7 Journal of the American Academy of Dermatology Amsterdam [u.a.] : Elsevier, 1979 78, Seite 1119-1124 Online-Ressource (DE-627)320411745 (DE-600)2001404-1 (DE-576)094426791 1097-6787 nnns volume:78 pages:1119-1124 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.93 Dermatologie AR 78 1119-1124 |
| allfieldsGer |
10.1016/j.jaad.2017.12.048 doi (DE-627)ELV002579545 (ELSEVIER)S0190-9622(17)32888-8 DE-627 ger DE-627 rda eng 610 DE-600 44.93 bkl Rogers, Emma M. verfasserin aut Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer Connolly, Karen L. verfasserin aut Nehal, Kishwer S. verfasserin aut Dusza, Stephen W. verfasserin aut Rossi, Anthony M. verfasserin aut Lee, Erica verfasserin aut Enthalten in American Academy of Dermatology ; ID: gnd/1053786-7 Journal of the American Academy of Dermatology Amsterdam [u.a.] : Elsevier, 1979 78, Seite 1119-1124 Online-Ressource (DE-627)320411745 (DE-600)2001404-1 (DE-576)094426791 1097-6787 nnns volume:78 pages:1119-1124 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.93 Dermatologie AR 78 1119-1124 |
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10.1016/j.jaad.2017.12.048 doi (DE-627)ELV002579545 (ELSEVIER)S0190-9622(17)32888-8 DE-627 ger DE-627 rda eng 610 DE-600 44.93 bkl Rogers, Emma M. verfasserin aut Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer Connolly, Karen L. verfasserin aut Nehal, Kishwer S. verfasserin aut Dusza, Stephen W. verfasserin aut Rossi, Anthony M. verfasserin aut Lee, Erica verfasserin aut Enthalten in American Academy of Dermatology ; ID: gnd/1053786-7 Journal of the American Academy of Dermatology Amsterdam [u.a.] : Elsevier, 1979 78, Seite 1119-1124 Online-Ressource (DE-627)320411745 (DE-600)2001404-1 (DE-576)094426791 1097-6787 nnns volume:78 pages:1119-1124 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.93 Dermatologie AR 78 1119-1124 |
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610 DE-600 44.93 bkl Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer comorbidity elderly limited life expectancy NMSC Mohs micrographic surgery skin cancer |
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ddc 610 bkl 44.93 misc comorbidity misc elderly misc limited life expectancy misc NMSC misc Mohs micrographic surgery misc skin cancer |
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Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
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Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
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Rogers, Emma M. |
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Journal of the American Academy of Dermatology |
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Rogers, Emma M. Connolly, Karen L. Nehal, Kishwer S. Dusza, Stephen W. Rossi, Anthony M. Lee, Erica |
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Rogers, Emma M. |
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10.1016/j.jaad.2017.12.048 |
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comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
| title_auth |
Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
| abstract |
Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. |
| abstractGer |
Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. |
| abstract_unstemmed |
Background: There is controversy regarding treatment of nonmelanoma skin cancer (NMSC) in very elderly individuals, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the population of very elderly individuals with NMSC has not been well defined.Objective: Define comorbidity scores associated with LLE in very elderly individuals presenting for management of NMSC.Methods: A retrospective review of 488 patients age 85 or older presenting for NMSC management between July 1999 through December 2014 was performed. Comorbidities were scored by using the Adult Comorbidity Evaluation-27 (ACE-27) and age-adjusted Charlson comorbidity index (ACCI). Dates of death, follow-up, and overall survival were determined.Results: ACE-27 and ACCI scores were associated with overall survival; at scores of 3 and 7+, respectively, both were associated with less than 50% survival at 4 years. Patients who underwent Mohs micrographic surgery survived a median of 20 months longer than patients who did not.Limitations: Retrospective study design and referral bias.Conclusions: ACE-27 and ACCI scores predicted LLE. The cohort presenting for Mohs micrographic surgery had improved survival, despite similar intercohort comorbidity. This suggests that additional factors contributed to survival and that age and comorbidities alone are inadequate for making NMSC treatment decisions in very elderly individuals. |
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Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer |
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