高危皮肤鳞状细胞癌的检查和管理的不断发展的范例。

An evolving paradigm for the workup and management of high-risk cutaneous squamous cell carcinoma.

机构信息

Department of Dermatology, Division of Dermatologic Surgery, Columbia University Medical Center, New York, New York.

出版信息

J Am Acad Dermatol. 2013 Oct;69(4):595-602.e1. doi: 10.1016/j.jaad.2013.05.011. Epub 2013 Jul 17.

DOI:10.1016/j.jaad.2013.05.011

PMID:23871719

Abstract

BACKGROUND

No established standard of care exists for aggressive cutaneous squamous cell carcinoma (CSCC).

OBJECTIVE

We sought to establish an aggressive CSCC management protocol by reviewing high-risk CSCC (HCSCC) and very high-risk CSCC (VCSCC) cases at our institution.

METHODS

This was a retrospective review of all CSCC cases treated at our institution.

RESULTS

A total of 27 patients were identified of 1591 cases treated between 2000 and 2011. Four patients with HCSCC received surgery alone and 1 received surgery and radiation. All remain disease free (median follow-up 5 years). Among patients with VCSCC, 4 received surgery alone: 1 (25%) showing a complete response and 3 (75%) showing disease progression. Eleven received surgery and radiation: 4 (36.4%) with complete response (median follow-up 3 years) and 7 (63.6%) with disease progression (median time to recurrence 6 months). Six received surgery and cetuximab: 3 (50%) had a complete response (median follow-up 3 years), 2 (33%) had disease progression, and 1 (14%) could not be assessed because of inability to tolerate infusions. One patient received surgery, cetuximab, and radiation, and remains disease-free after 4 years.

LIMITATIONS

Lack of randomization, blinding, a true control arm, or standardization of treatment protocols are limitations.

CONCLUSIONS

Patients with very HCSCC may have improved outcomes with surgery and adjuvant cetuximab.

摘要

背景

目前尚无侵袭性皮肤鳞状细胞癌（CSCC）的既定治疗标准。

目的

通过回顾本机构的高危 CSCC（HCSCC）和极高危 CSCC（VCSCC）病例，我们旨在建立侵袭性 CSCC 的管理方案。

方法

这是对本机构治疗的所有 CSCC 病例进行的回顾性研究。

结果

在 2000 年至 2011 年期间，共确定了 1591 例患者中的 27 例。4 例 HCSCC 患者仅接受手术治疗，1 例接受手术和放疗。所有患者均未出现疾病（中位随访 5 年）。在 VCSCC 患者中，4 例仅接受手术治疗：1 例（25%）完全缓解，3 例（75%）疾病进展。11 例接受手术和放疗：4 例（36.4%）完全缓解（中位随访 3 年），7 例（63.6%）疾病进展（中位复发时间 6 个月）。6 例接受手术和西妥昔单抗治疗：3 例（50%）完全缓解（中位随访 3 年），2 例（33%）疾病进展，1 例（14%）因无法耐受输注而无法评估。1 例患者接受手术、西妥昔单抗和放疗，4 年后仍无疾病。