BACKGROUND A retrospective cohort study was undertaken to examine the management of basal cell carcinoma (BCC) in older patients. OBJECTIVES The aim was to identify subgroups where intervention could be minimised, based on frailty and trends in survival. METHODS All patients aged 90 years and over with histologically confirmed BCC during 2017 and 2018 were included within the study (n = 319). RESULTS Age was the most significant predictor of survival (HR=1.10 (95% CIs: 1.04-1.17); p=0.001). Maximum threshold analysis identified 93 years as the significant age cutpoint. Median survival was 40 months for ≤93 years and 28 months for >93 years (p=0.002). Patients with dementia had a worse survival than those without (median survival: 25 months versus 35 months, respectively; HR=1.92 (95% CIs: 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 those observed (n=25) (median survival 34 months versus 21 months, respectively; HR= 0.54 (95% CIs: 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.

中文翻译：

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90 岁及以上个体基底细胞癌治疗的临床结果 - 一项回顾性队列研究。


背景 一项回顾性队列研究旨在检查老年患者基底细胞癌 (BCC) 的治疗。目的 目的是根据虚弱程度和生存趋势确定可以最小化干预的亚组。方法 2017 年和 2018 年期间所有经组织学证实患有 BCC 的 90 岁及以上患者均纳入研究（n = 319）。结果年龄是最重要的生存预测因子（HR=1.10（95% CI：1.04-1.17）；p=0.001）。最大阈值分析确定 93 岁为重要的年龄分界点。 ≤93岁的中位生存期为40个月，>93岁的中位生存期为28个月（p=0.002）。患有痴呆症的患者比没有痴呆症的患者生存期更差（中位生存期分别为 25 个月和 35 个月；HR=1.92（95% CI：1.18-3.13）；p=0.009）。接受 BCC 治疗的患者 (n=294) 与观察患者 (n=25) 相比，生存率存在统计学显着差异（中位生存期分别为 34 个月与 21 个月；HR= 0.54（95% CI：0.34- 0.85）；p=0.007）。检查的所有其他合并症对生存没有影响。结论 本研究提供了证据支持对二级护理中年龄≥90 岁的个体进行积极治疗 BCC。对于痴呆症患者或 93 岁以上的患者，保守治疗可能更可取。