Tourli I, Langner D, Haroske G, Tchernev G, Lotti T, Wollina U
Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; Institute of Pathology "Georg Schmorl", Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; Ambulatory Clinic for Dermatology and Venereology, University Hospital Lozenetz, Sofia, Bulgaria; Chair of Dermatology at University of Rome "G. Marconi", Rome, Italy.
Georgian Med News. 2016 Jan(250):33-9.
Basal cell carcinoma (BCC) is the most common malignancy in humans with a pre-dominance for the sun-exposed head-and-neck region. Its incidence is rising world-wide. Early detection and appropriate treatment ensures an excellent prognosis. We analyzed patients with BCC of the head-and-neck region treated at our Department from January 2008 to December 2012 with a follow-up between 2 to 6 years. Data were collected retrospectively. During a 4-year period, 1,750 BCC lesions of head-and-neck region were excised from 1,380 patients. Distribution of gender among the patients was nearly even. Mean age of patients was 74.3±11.4 years. Solid histological subtype dominated the series. Most tumors were removed surgically by delayed MOHS technique (77.0%). The recurrence rate of BCC was 1.6%. The highest recurrence rate of 15.5% was seen in cases of morphea-like BCC compared to 3.9% among solid BCC. The recurrence rate among R0 resected tumors was 0.24% compared to 19.8% among R1-resections (Pearson's Chi-square 56.000). The majority of recurrences occurred within the first 5 year-interval (64%). Multivariate analysis of risk factors for recurrences demonstrated an Odd's ratio for recurrences of 54.89 (95% confidence interval, 21.16, 142.37) in case of R1-resection status. Gender had a minor influence with a slight benefit toward males versus females (Odd's ratio 0.51; 95% confidence interval, 0.28, 0.92). The age of the patients had no impact on recurrence rate. Although there is relatively low mortality attributable to BCC, the morbidity and cost of treatment are significant. Surgical excision remains the mainstay of treatment. For head-and-neck BCC, delayed MOHS surgery offers significantly lower recurrence in both primary BCC and recurrent (secondary) BCC.
基底细胞癌（BCC）是人类最常见的恶性肿瘤，主要发生于头颈部暴露于阳光的区域。其发病率在全球范围内呈上升趋势。早期发现并进行适当治疗可确保良好的预后。我们分析了2008年1月至2012年12月在我院接受治疗的头颈部基底细胞癌患者，随访时间为2至6年。数据采用回顾性收集。在4年期间，从1380例患者中切除了1750例头颈部基底细胞癌病变。患者的性别分布几乎均匀。患者的平均年龄为74.3±11.4岁。实体组织学亚型在该系列中占主导地位。大多数肿瘤通过延迟Mohs技术手术切除（77.0%）。基底细胞癌的复发率为1.6%。硬斑病样基底细胞癌的复发率最高，为15.5%，而实体型基底细胞癌的复发率为3.9%。R0切除肿瘤的复发率为0.24%，而R1切除的复发率为19.8%（Pearson卡方检验值为56.000）。大多数复发发生在最初的5年间隔内（64%）。对复发危险因素的多因素分析显示，R1切除状态下复发的比值比为54.89（95%置信区间，21.16，142.37）。性别影响较小，男性比女性略有优势（比值比0.51；95%置信区间，0.28，0.92）。患者年龄对复发率没有影响。尽管基底细胞癌导致的死亡率相对较低，但发病率和治疗成本却很高。手术切除仍然是主要的治疗方法。对于头颈部基底细胞癌，延迟Mohs手术在原发性基底细胞癌和复发性（继发性）基底细胞癌中均能显著降低复发率。
