• PDT combined with surgery provides an effective treatment for older patients with mucosal malignancies. • PDT combined with minimally invasive resection could reduce operative time, lower perioperative risk, and preserve anatomical integrity and physiological function. The incidence of cutaneous malignancies is increasing among older adults. In frail older patients, standard wide excision of mucosal carcinomas often leads to extensive tissue defects, prolonged surgical duration, and deeper anesthesia requirements, all of which elevate perioperative risk. At anatomically complex sites, such as the oral cavity or perineal mucosa, surgery is complicated by the dual challenge of achieving clear margins while preserving function. Consequently, local recurrence rates at these sites substantially exceed those of comparable cutaneous malignancies. To evaluate the efficacy and safety of extended local excision guided by intraoperative frozen-section analysis, followed by postoperative photodynamic therapy (PDT), in older patients with mucosal malignancies. Following surgical resection with confirmed clear margins, the patient underwent three sessions of adjuvant PDT. The treated lesion exhibited prompt re-epithelialization with erythema and granulation tissue formation, and no exudate or residual tumor was observed. Serial reflectance confocal microscopy during the 12-month follow-up revealed no atypical cells. The patient’s quality of life improved significantly. The combined approach of extended resection with adjuvant PDT appears to ensure oncological safety, reduce surgical invasiveness, and preserve mucosal function in high-risk older patients. This combination represents a promising single-stage treatment strategy.
Zuo et al. (Sun,) studied this question.