Stasko Thomas, Brown Marc D, Carucci John A, Euvrard Sylvie, Johnson Timothy M, Sengelmann Roberta D, Stockfleth Eggert, Tope Whitney D
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Dermatol Surg. 2004 Apr;30(4 Pt 2):642-50. doi: 10.1111/j.1524-4725.2004.30150.x.
Solid-organ transplant recipients have a high incidence of cutaneous squamous cell carcinoma (SCC) and often develop multiple and aggressive tumors. There are few published studies or reviews, which provide guidance to the clinician in the treatment of these patients.
The objective was to develop useful clinical guidelines for the treatment of skin cancer in organ transplant recipients (OTRs).
The members of the Guidelines Committee of the International Transplant-Skin Cancer Collaborative (ITSCC) carried out a computerized search utilizing the databases of the National Library of Medicine for reports in the literature on SCC in OTRs. These reports were collectively examined by the group and combined with experiences from the members' clinical practices in the development of the guidelines.
More than 300 articles relating to SCC in OTRs were reviewed. In general, reports concerning the prevention and treatment of SCC in OTRs are of individual cases or small case series. They are retrospective in nature, statistically nonrigorous, and lack the complete epidemiologic data necessary to derive definitive conclusions. Combining these studies and collective clinical experience, however, is at present the best available method for devising guidelines for the treatment of SCC in OTRs.
Guidelines developed for the treatment of skin cancer in OTRs, supported by the best available data and collective clinical experience, may assist in the management of OTRs with SCC. The development of clinical pathways and complete documentation with rigorous prospective study is necessary to improve and refine future guideline development.
实体器官移植受者皮肤鳞状细胞癌(SCC)的发病率很高,且常发生多发性侵袭性肿瘤。鲜有已发表的研究或综述为临床医生治疗这些患者提供指导。
制定针对器官移植受者(OTR)皮肤癌治疗的实用临床指南。
国际移植-皮肤癌协作组(ITSCC)指南委员会成员利用美国国立医学图书馆数据库对文献中有关OTR的SCC报告进行了计算机检索。该小组对这些报告进行了综合审查,并结合成员临床实践经验制定指南。
共检索并审查了300多篇与OTR的SCC相关的文章。总体而言,关于OTR的SCC预防和治疗的报告多为个案或小病例系列。这些报告本质上是回顾性的,统计学上不严谨,且缺乏得出明确结论所需的完整流行病学数据。然而,将这些研究与集体临床经验相结合,是目前为OTR的SCC制定治疗指南的最佳可用方法。
基于现有最佳数据和集体临床经验制定的OTR皮肤癌治疗指南,可能有助于管理患有SCC的OTR。有必要制定临床路径并通过严格的前瞻性研究进行完整记录,以改进和完善未来的指南制定。