Potter Benjamin K, Pitcher J David, Adams Sheila C, Temple H Thomas
Integrated Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Bldg 2, Clinic 5A, Washington, DC 20307, USA.
Foot Ankle Int. 2009 Jun;30(6):517-23. doi: 10.3113/FAI.2009.0517.
Squamous cell carcinomas (SCC) of the foot are relatively common, but have been infrequently reported in the orthopaedic literature.
Twelve patients with SCC of the foot treated at a single institution from 1998 to 2005 were studied retrospectively with regard to risk factors for the disease, treatment, and functional and oncologic outcomes. The mean duration of postoperative followup was 43 (range, 24 to 105) months.
Eight of the 12 patients had identifiable risk factors for SCC. Inadequate or inappropriate procedures had been previously performed in eight of the 12 cases, requiring more aggressive definitive treatment in at least four cases. Definitive operative treatment consisted of wide excision (4 patients), partial or complete toe amputation (4), partial foot amputation (3), and transtibial amputation (1). Two patients developed local recurrence of disease, and both ultimately required Syme amputations for local control. One patient with local recurrence died of metastatic disease and the other 11 patients are alive without evident disease. Musculoskeletal Tumor Society functional scores averaged 90 and were good or excellent in nine of the 11 surviving patients.
Squamous cell carcinomas of the foot are likely underreported and frequently subject to inappropriate initial treatment. Most patients have identifiable risk factors for SCC that can aid in formulating an appropriate differential diagnosis. Despite frequent suboptimal initial treatment, most patients are candidates for complete or partial limb salvage, with generally good oncologic and functional outcomes expected.
足部鳞状细胞癌（SCC）相对常见，但在骨科文献中报道较少。
回顾性研究了1998年至2005年在单一机构接受治疗的12例足部SCC患者的疾病危险因素、治疗方法以及功能和肿瘤学结果。术后平均随访时间为43个月（范围24至105个月）。
12例患者中有8例具有SCC的可识别危险因素。12例中有8例先前接受过不充分或不恰当的手术，其中至少4例需要更积极的确定性治疗。确定性手术治疗包括广泛切除（4例）、部分或全部趾截肢（4例）、部分足部截肢（3例）和经胫骨截肢（1例）。2例患者出现疾病局部复发，最终均需要进行Syme截肢以控制局部病变。1例局部复发患者死于转移性疾病，其他11例患者存活且无明显疾病。肌肉骨骼肿瘤学会功能评分平均为90分，11例存活患者中有9例评分良好或优秀。
足部鳞状细胞癌可能报道不足，且常常接受不恰当的初始治疗。大多数患者具有SCC的可识别危险因素，有助于制定合适的鉴别诊断。尽管初始治疗常常欠佳，但大多数患者适合进行肢体部分或全部挽救，预期肿瘤学和功能结果总体良好。
