Schinstine M, Goldman G D
University of Vermont College of Medicine and Fletcher Allen Health Care Center, UHC Campus, Burlington, Vermont 05401, USA.
J Am Acad Dermatol. 2001 Mar;44(3):497-9. doi: 10.1067/mjd.2001.110646.
Patients with basal cell carcinoma and cutaneous squamous cell carcinoma are at substantial risk for the onset of a second nonmelanoma skin cancer (NMSC).
Our purpose was to determine the incidence of multiple (synchronous) NMSC at presentation to an academic Mohs micrographic surgery referral center and to note the incidence of second lesions occurring in a metachronous fashion.
A retrospective study was conducted of 456 consecutive patients who presented for Mohs surgery over a 2-year period. Patients were assessed at initial visits for the presence of multiple NMSCs and were subsequently examined over 2 years for the onset of new NMSCs.
More than 39% of patients initially referred for Mohs surgery with a basal cell or squamous cell carcinoma either presented with multiple primary lesions or experienced a subsequent NMSC within 2 years. These tumors were divided almost equally between multiple primary NMSC at presentation and subsequent (metachronous) tumors.
Patients referred for Mohs surgery in an academic setting are a select group at extremely high risk of additional NMSCs at or shortly after presentation for the index lesion.
基底细胞癌和皮肤鳞状细胞癌患者发生第二种非黑色素瘤皮肤癌（NMSC）的风险很大。
我们的目的是确定在一家学术性莫氏显微外科转诊中心就诊时多发（同步）NMSC的发生率，并记录异时发生的第二种病变的发生率。
对在两年期间连续接受莫氏手术的456例患者进行了一项回顾性研究。在初次就诊时评估患者是否存在多发NMSC，随后在两年内对患者进行检查，以观察新的NMSC的发生情况。
最初因基底细胞癌或鳞状细胞癌而转诊接受莫氏手术的患者中，超过39%的患者要么初诊时就有多个原发性病变，要么在两年内出现了后续的NMSC。这些肿瘤在初诊时的多发原发性NMSC和后续（异时性）肿瘤之间几乎平均分布。
在学术环境中被转诊接受莫氏手术的患者是一个特定的群体，在因索引病变就诊时或就诊后不久发生额外NMSC的风险极高。
