South East Dermatology, Brisbane, Queensland, Australia.
Australas J Dermatol. 2009 Nov;50(4):261-5. doi: 10.1111/j.1440-0960.2009.00555.x.
Currently, the National Health and Medical Research Council do not have any recommendations about the frequency of follow up after treatment of primary cutaneous invasive squamous cell cancer (SCC), due to a lack of data. The present study aimed to establish appropriate follow-up times and to determine the long-term risk of subsequent non-melanoma skin cancers and melanoma. Patients who had a primary invasive cutaneous SCC excised during 1996 were retrospectively identified from the databases of a dermatologist in private practice in south-east Queensland. Data on size, site, depth, differentiation, perineural involvement, lymphovascular involvement of the index SCC were obtained. The patients were regularly followed up and lymph-node involvement, patient immunocompetence, and the presence of local recurrences and subsequent SCC, basal cell carcinomas and melanoma were recorded. Forty patients were identified, comprising 25 men and 15 women with a mean age of 65 years. The majority (60%) of primary incident SCC were in the low-risk category. The median follow-up time was 7.5 years. One in two developed a second SCC within 5 years, a significant number had a second SCC detected only in 5-10 year follow up, and 72.5% had a BCC within 5 years, and 82.5% at 10 years. One in eight had a subsequent melanoma detected.
目前,由于缺乏数据,国家卫生和医学研究委员会(National Health and Medical Research Council)对原发性皮肤浸润性鳞状细胞癌(SCC)治疗后的随访频率没有任何建议。本研究旨在确定适当的随访时间,并确定随后发生非黑色素瘤皮肤癌和黑色素瘤的长期风险。本研究从昆士兰州东南部一位私人执业皮肤科医生的数据库中回顾性地确定了在 1996 年接受原发性浸润性皮肤 SCC 切除的患者。获得了关于肿瘤大小、部位、深度、分化、神经周围浸润、指数 SCC 的血管淋巴管浸润的数据。对患者进行定期随访,并记录淋巴结受累、患者免疫功能、局部复发以及随后的 SCC、基底细胞癌和黑色素瘤的情况。共确定了 40 名患者,包括 25 名男性和 15 名女性,平均年龄为 65 岁。大多数(60%)原发性 SCC 处于低风险类别。中位随访时间为 7.5 年。有二分之一的患者在 5 年内发生了第二次 SCC,相当一部分患者在 5-10 年随访时才发现第二次 SCC,72.5%的患者在 5 年内发生了基底细胞癌,82.5%的患者在 10 年内发生了基底细胞癌。有八分之一的患者随后被发现患有黑色素瘤。