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100例连续性耳廓非黑色素瘤皮肤癌刮除术联合冷冻手术的五年疗效

Five-year results of curettage-cryosurgery for 100 consecutive auricular non-melanoma skin cancers.

作者信息

Nordin Peter, Stenquist Bo

机构信息

Departments of Dermatology, Frölunda Specialist Hospital and Lundby Hospital, Gothenburg, Sweden.

出版信息

J Laryngol Otol. 2002 Nov;116(11):893-8. doi: 10.1258/00222150260369390.

Abstract

Large excisions or Mohs' micrographic surgery (MMS) are often the suggested treatments for non-melanoma skin cancers (NMSCs) of the external ear. This five-year follow-up attempts to evaluate whether curettage-cryosurgery could be an alternative therapy for selected auricular NMSCs. One hundred auricular NMSCs, selected at a skin tumour clinic, were treated by a thorough curettage, with different-sized curettes, followed by cryosurgery in a double freeze-thaw cycle. Seventy-seven basal cell carcinomas (BCCs), 13 squamous cell carcinomas (SCCs), six SCCs in situ, and four basosquamous carcinomas were included. The mean diameter of the tumours was 18 mm (range 5-70). Morphoeiform BCCs, recurrent BCCs with fibrotic component, and most of the SCCs were selected for MMS. Seventy-one patients with 81 tumours were followed-up for at least five years with only one recurrence. Nineteen patients with 19 tumours, followed-up for two to four years, died from other causes with no sign of recurrence at their last visit. Patients followed-up for less than two years were excluded. No major problems were registered after treatment. The cosmetic result was good or acceptable in most patients. In carefully selected patients a thorough curettage followed by freezing with liquid nitrogen in a double freeze-thaw cycle could be a safe and inexpensive therapy even for large NMSCs of the external ear.

摘要

对于外耳非黑色素瘤皮肤癌(NMSC),通常建议进行大面积切除或莫氏显微外科手术(MMS)。这项为期五年的随访旨在评估刮除术 - 冷冻手术是否可作为部分耳廓NMSC的替代疗法。在一家皮肤肿瘤诊所挑选了100例耳廓NMSC患者,先用不同尺寸的刮匙进行彻底刮除,然后进行双冻融循环的冷冻手术。其中包括77例基底细胞癌(BCC)、13例鳞状细胞癌(SCC)、6例原位SCC和4例基底鳞状细胞癌。肿瘤的平均直径为18毫米(范围5 - 70毫米)。浸润性BCC、伴有纤维化成分的复发性BCC以及大多数SCC被选作MMS治疗对象。71例患有81个肿瘤的患者接受了至少五年的随访,仅有1例复发。19例患有19个肿瘤的患者接受了两到四年的随访,死于其他原因,最后一次就诊时无复发迹象。随访时间不足两年的患者被排除。治疗后未记录到重大问题。大多数患者的美容效果良好或可接受。对于精心挑选的患者,即使是外耳较大的NMSC,彻底刮除后进行双冻融循环的液氮冷冻也可能是一种安全且廉价的治疗方法。

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