Pazdrowski Jakub, Dańczak-Pazdrowska Aleksandra, Golusiński Paweł, Szybiak Bartosz, Silny Wojciech, Golusiński Wojciech
Oddział Chirurgii Głowy i Szyi i Onkologii Laryngologicznej Wielkopolskiego Centrum Onkologii.
Otolaryngol Pol. 2012 May-Jun;66(3):185-90. doi: 10.1016/S0030-6657(12)70767-9.
The incidence of basal-cell carcinomas (BCC) in Europe is estimated at 10 cases per 100,000 people and is continuously increasing. Recurrent cases of BCC tend to have a more aggressive progression. The treatment methods include: conventional surgery, Mohs surgery, laser therapy, cryosurgery, curettage and radiotherapy. The recurrence of basalcell carcinoma depends on the method of treatment and ranges between 4% and 18%. In the case of recurrent BCC the treatment method of choice is margin control surgery.
The purpose of this paper is to conduct a retrospective analysis of patients with facial BCC treated with classic surgery and laser therapy as well as to present a strategy for action in the case of recurrence.
The retrospective analysis was conducted on patients with diagnosed facial BCC, treated at the Head and Neck Surgery Ward and Laryngological Oncology Clinic of the Greater Poland Cancer Centre in the years 2007-2010. The research included 58 patients aged 56-80; 34 women and 24 men.
Out of 58 patients 8 had recurrent BCC - 4 cases after laser therapy (Group A), and 4 cases after classic surgery (Group B). In 2 cases from Group A and all cases from Group B further treatment involved removal of the recurrent tumour by margin control surgery and skin flap plastic surgery. In 2 remaining cases from Group A further CO(2) laser therapy was performed under local anaesthesia and analgosedation. This type of treatment was chosen due to general medical and cardiological concerns which disqualified the use of general anaesthesia and conventional surgery. So far no further local recurrent cases of BCC have been diagnosed, and the follow-up periods range from 4 to 26 months.
Recurrent cases of BCC are 10% more frequent in patients treated with cryosurgery or laser therapy without margin control than in patients who had the tumour removed by margin control surgery. Margin control surgery remains the method of choice in cases involving large tumours, recurrence or spread by invasion.
欧洲基底细胞癌（BCC）的发病率估计为每10万人中有10例，且呈持续上升趋势。复发性基底细胞癌病例往往进展更为侵袭性。治疗方法包括：传统手术、莫氏手术、激光治疗、冷冻手术、刮除术和放射治疗。基底细胞癌的复发取决于治疗方法，复发率在4%至18%之间。对于复发性基底细胞癌，首选的治疗方法是边缘控制手术。
本文旨在对接受经典手术和激光治疗的面部基底细胞癌患者进行回顾性分析，并提出复发情况下的应对策略。
对2007年至2010年在大波兰癌症中心头颈外科病房和喉科肿瘤诊所接受治疗的确诊面部基底细胞癌患者进行回顾性分析。研究纳入了58名年龄在56至80岁之间的患者；34名女性和24名男性。
58名患者中有8例出现复发性基底细胞癌——激光治疗后4例（A组），经典手术后4例（B组）。A组的2例和B组的所有病例进一步治疗包括通过边缘控制手术和皮瓣整形手术切除复发性肿瘤。A组其余2例在局部麻醉和镇痛镇静下进一步进行二氧化碳激光治疗。选择这种治疗方式是由于患者的一般医疗和心脏问题，不适合使用全身麻醉和传统手术。到目前为止，尚未诊断出进一步的局部复发性基底细胞癌病例，随访期为4至26个月。
与通过边缘控制手术切除肿瘤的患者相比，在未进行边缘控制的冷冻手术或激光治疗的患者中，复发性基底细胞癌病例的发生率高10%。对于涉及大肿瘤、复发或侵袭性扩散的病例，边缘控制手术仍然是首选方法。
