Ducic Yadranko, Marra Diego E, Kennard Charles
Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, USA.
Laryngoscope. 2009 Apr;119(4):774-7. doi: 10.1002/lary.20096.
To review our experience with Mohs excision of massive cutaneous carcinomas for peripheral margin control, followed by planned definitive resection of the deeply invasive component of the carcinoma.
Retrospective review.
All cases of massive (at least 10 cm in dimension) cutaneous carcinomas treated by the technique outlined by Yadranko Ducic from 1998-2006.
A total of 28 cases (7 squamous cell carcinomas, 14 basal cell carcinomas, 7 basosquamous carcinomas) were treated in this manner. Average maximal tumor dimension was 12.7 cm with a range of 10-21 cm. None of the patients recurred at the peripheral margin at an average follow-up of 3.2 years. There were a total of 7 local recurrences (5 squamous cell carcinoma and 2 basal cell carcinoma). All recurrences occurred within the deep resection bed.
The technique appears to be an excellent means of treatment of massive, neglected, and deeply invasive cutaneous carcinomas of the face and neck. It allows for more precise margin control than can be afforded by surgical pathology, decreases length of anesthesia, and enables the surgeon to more accurately plan the required reconstruction to review with the patient preoperatively.
回顾我们采用莫氏手术切除巨大皮肤癌以控制周边切缘，随后对癌的深部浸润成分进行计划性根治性切除的经验。
回顾性研究。
所有1998年至2006年采用亚德兰卡·杜西奇概述的技术治疗的巨大（尺寸至少10厘米）皮肤癌病例。
共28例（7例鳞状细胞癌、14例基底细胞癌、7例基底鳞状细胞癌）采用这种方式治疗。肿瘤平均最大尺寸为12.7厘米，范围为10至21厘米。平均随访3.2年，所有患者周边切缘均未复发。共有7例局部复发（5例鳞状细胞癌和2例基底细胞癌）。所有复发均发生在深部切除床内。
该技术似乎是治疗面部和颈部巨大、被忽视且深部浸润性皮肤癌的一种极佳方法。它比手术病理学能提供更精确的切缘控制，缩短麻醉时间，并使外科医生能够更准确地规划所需的重建，以便术前与患者沟通。
