Dept of Radiation Oncology Sydney, Westmead Hospital, New South Wales, Australia.
Australas J Dermatol. 2010 May;51(2):113-7. doi: 10.1111/j.1440-0960.2009.00576.x.
Cutaneous squamous cell carcinoma accounts for 20% of all non-melanoma skin cancer with a minority arising on the trunk and extremities. A small proportion will develop metastases to regional nodes of the axilla or groin. We performed a retrospective review of patients with metastatic cutaneous squamous cell carcinoma to the axilla and groin treated at Westmead Hospital, Sydney. The purpose of this study was to document the treatment and outcome of these patients. We identified 18 men and 8 women with a median age of 73 years. Median follow-up was 18.5 months. Median lesion size was 27 mm (range 3-130 mm) and median thickness was 7 mm (range 3-32 mm). Nine patients developed metastases to the groin, 14 to the axilla, 1 in the epitrochlear, and 2 to both the epitrochlear and axillary lymph nodes. All patients were treated with surgery +/- radiotherapy. Recurrence developed in seven patients (27%) with most developing distant metastases. Most (6/7) patients with recurrence died. Predicting patients that may develop nodal metastatic non-head and neck cutaneous squamous cell carcinoma is difficult. Following diagnosis, surgery remains the primary treatment and select patients with unfavourable features, such as extranodal spread, may benefit from the addition of adjuvant radiotherapy.
皮肤鳞状细胞癌占所有非黑色素瘤皮肤癌的 20%，少数发生在躯干和四肢。少数会发展为腋窝或腹股沟区域淋巴结转移。我们对在悉尼 Westmead 医院接受腋窝和腹股沟转移性皮肤鳞状细胞癌治疗的患者进行了回顾性研究。本研究的目的是记录这些患者的治疗和结果。我们确定了 18 名男性和 8 名女性，中位年龄为 73 岁。中位随访时间为 18.5 个月。中位病变大小为 27 毫米（范围 3-130 毫米），中位厚度为 7 毫米（范围 3-32 毫米）。9 名患者发生腹股沟转移，14 名患者发生腋窝转移，1 名患者发生内上髁转移，2 名患者发生内上髁和腋窝淋巴结转移。所有患者均接受手术 +/-放疗。7 名患者（27%）出现复发，大多数患者出现远处转移。大多数（6/7）复发患者死亡。预测可能发生非头颈部皮肤鳞状细胞癌淋巴结转移的患者是困难的。诊断后，手术仍然是主要治疗方法，对于有不利特征的患者，如结外扩散，辅助放疗可能有益。
