Jellouli-Elloumi A, Kochbati L, Dhraief S, Ben Romdhane K, Maalej M
Service de Dermatologie, Hôpital Ettadhamen, Ariana, Tunisie.
Ann Dermatol Venereol. 2003 Apr;130(4):413-6.
The development of cancer from burn scars is rare but not exceptional since 1 to 2 p. 100 of cutaneous cancers develop on burn scars.
We report a retrospective study of 62 cases arising from burn scars that account for 25 years at the Institute Salah Azaiez in Tunis. The epidemiological, clinic and prognosis characteristics of these cancers are discussed.
Forty-five patients were male and seventeen were female. Their age varied from 22 to 83 years, with a mean age of 51.5 years. Limbs were affected in 85 p. 100 of the cases and the lower limbs in 58 p. 100. The mean size of the tumour was of 97 mm. Squamous cell carcinomas were the most frequent cancers arising from burn scar (95 p. 100). Basal cell carcinoma is arising only in two cases and malignant melanoma in one case. The treatment was curative for 49 patients: surgery and radiotherapy (31 cases), surgery only (14 cases) and radiotherapy (4 cases). The overall survival at 2 years, 3 years and 5 years was respectively 49.5 p. 100; 41.5 p. 100 and 37 p. 100.
The improvement of prognosis depends not only on an earlier diagnosis and treatment, but also on the appropriate management of burns when they occurred.
烧伤瘢痕发生癌变虽罕见但并非个例,因为每100例皮肤癌中有1至2例发生于烧伤瘢痕。
我们对突尼斯萨拉赫·阿扎耶兹研究所25年间发生的62例烧伤瘢痕癌病例进行了回顾性研究。讨论了这些癌症的流行病学、临床及预后特征。
45例为男性,17例为女性。年龄从22岁至83岁不等,平均年龄为51.5岁。85%的病例累及四肢,58%累及下肢。肿瘤平均大小为97毫米。鳞状细胞癌是烧伤瘢痕最常见的癌症(95%)。基底细胞癌仅2例,恶性黑色素瘤1例。49例患者治疗有效:手术加放疗(31例)、单纯手术(14例)和单纯放疗(4例)。2年、3年和5年总生存率分别为49.5%、41.5%和37%。
预后的改善不仅取决于早期诊断和治疗,还取决于烧伤发生时的恰当处理。