Rieger Kerri E, Linos Eleni, Egbert Barbara M, Swetter Susan M
Department of Dermatology, Stanford University Medical Center, Stanford, CA 94305, USA.
J Cutan Pathol. 2010 Jan;37(1):59-67. doi: 10.1111/j.1600-0560.2009.01340.x. Epub 2009 Jul 13.
Reported recurrence rates for transected nonmelanoma skin cancer (NMSC) vary widely, and few studies have addressed recurrence of tumors followed clinically or treated with nonsurgical modalities.
Retrospective review of dermatopathology records from January 1999 to January 2005 was conducted to identify biopsies or excision specimens with histologically transected basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) which were not subsequently excised. Patient and tumor characteristics associated with recurrence were analyzed in a subgroup of patients with predominantly 'low-risk' and/or minimally transected NMSCs. Prospective follow up was performed through March 31, 2008. Data was analyzed with Chi-square and Fishers exact tests and multivariate logistic regression.
Of 376 transected NMSCs, 27 (7.2%) recurred, including 20 (9%) of 223 BCCs and 7 (4.6%) SCCs in situ of 153 SCCs. The overall recurrence rate of the 124 minimally transected NMSCs was even lower (5.6%). Multivariate logistic regression identified three significant predictors of recurrence: tumor location on the head and neck (p = 0.041), tumor size (p = 0.00741) and superficial subtype of BCC (p = .035).
Although surgical excision of NMSC remains the standard of care, observation or nonsurgical treatment may be acceptable in many cases of incompletely excised low-risk or minimally transected NMSCs.
据报道，非黑色素瘤皮肤癌（NMSC）横断后的复发率差异很大，很少有研究涉及临床随访或采用非手术方式治疗的肿瘤复发情况。
回顾性分析1999年1月至2005年1月的皮肤病理学记录，以确定组织学上横断的基底细胞癌（BCC）和鳞状细胞癌（SCC）的活检或切除标本，这些标本随后未被切除。在主要为“低风险”和/或横断程度最小的NMSC患者亚组中，分析与复发相关的患者和肿瘤特征。前瞻性随访至2008年3月31日。采用卡方检验、Fisher精确检验和多因素逻辑回归分析数据。
在376例横断的NMSC中，27例（7.2%）复发，包括223例BCC中的20例（9%）和153例原位SCC中的7例（4.6%）。124例横断程度最小的NMSC的总体复发率更低（5.6%）。多因素逻辑回归确定了三个复发的重要预测因素：头颈部肿瘤位置（p = 0.041）、肿瘤大小（p = 0.00741）和BCC的浅表亚型（p = 0.035）。
虽然手术切除NMSC仍然是标准的治疗方法，但在许多低风险或横断程度最小的NMSC切除不完全的情况下，观察或非手术治疗可能是可以接受的。
