Head and neck skin carcinoma in elderly: surgical management

Skin carcinoma is the most common of human cancers. Multiple risk factors are recognized, including ultraviolet (UV) and ionizing radiation, chemical carcinogens, chronic wounds, immunosuppression and reduced DNA-repair mechanism.

The tumor occurs most frequently in individuals of 60 year of age and older and predominates in men.

Approximately 80% of tumors involve the head and neck regions, with almost 30% affecting the nose. Overall 80% of tumors can be completely eradicated with a simple technique, but recurrences are likely if therapy is not optimal. Recurrent lesions are more aggressive and difficult to treat. To ensure an adequate therapeutic plan the pathologist’s report should include not only the histological diagnosis and the adequacy of surgical margins but also the architectural variety of the tumor.

The presentation takes into consideration the author’s personal experience in the management of the primary lesions, focusing on the main surgical modality from the excision with adequate margins to skingrafting and flap reconstruction.

The surgical outcome and the main statistics are shown

The skin carcinomas in the elderly are relevant in terms of morbidity and mortality. Early diagnosis and optimal initial treatment are the keys for successful outcome.