Nahhas Amanda F, Scarbrough Chase A, Trotter Shannon
OhioHealth O'Bleness Hospital, Athens, Ohio.
Ohio State University Wexner Medical Center, Columbus, Ohio.
J Clin Aesthet Dermatol. 2017 Apr;10(4):37-46.
Adequate treatment and follow-up of a patient with nonmelanoma skin cancer is of utmost concern for a clinician. However, there is a lack of international consensus on recommendations for surgical excision margins. Furthermore, lack of familiarity of the published guidelines leads to a variety in practice styles. To compare the consistency in global recommendations for surgical excision margins for basal cell carcinoma, cutaneous squamous cell carcinoma, dermatofibrosarcoma protuberans, and Merkel cell carcinoma. A review of the current literature and global guidelines for surgical excision margins for basal cell carcinoma, cutaneous squamous cell carcinoma, dermatofibrosarcoma protuberans, and Merkel cell carcinoma. Upon review of international guidelines, variations do exist among guidelines for peripheral and deep surgical margins. Guideline recommendations were found to be more globally consistent in margin selection for low-risk basal cell carcinoma and low-risk cutaneous squamous cell carcinoma, however, least consistent when concerning margin selection for dermatofibrosarcoma protuberans and Merkel cell carcinoma. Although guidelines exist, there is a need for international collaboration and consensus to determine a more unified and evidence-based approach to surgical excision as a treatment for nonmelanoma skin cancer.
对于临床医生而言，对非黑色素瘤皮肤癌患者进行充分的治疗和随访至关重要。然而，关于手术切缘的建议缺乏国际共识。此外，对已发表指南的不熟悉导致了实践方式的多样性。为了比较全球对于基底细胞癌、皮肤鳞状细胞癌、隆突性皮肤纤维肉瘤和默克尔细胞癌手术切缘建议的一致性。对当前关于基底细胞癌、皮肤鳞状细胞癌、隆突性皮肤纤维肉瘤和默克尔细胞癌手术切缘的文献及全球指南进行综述。经审查国际指南发现，外周和深部手术切缘的指南之间确实存在差异。研究发现，对于低风险基底细胞癌和低风险皮肤鳞状细胞癌，指南在切缘选择方面的全球一致性更高，然而，在隆突性皮肤纤维肉瘤和默克尔细胞癌的切缘选择方面一致性最低。尽管已有指南，但仍需要国际合作和达成共识，以确定一种更统一且基于证据的手术切除方法，作为非黑色素瘤皮肤癌的治疗手段。
