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皮肤鳞状细胞癌的手术治疗:我们的经验。

Surgical therapy of cutaneous squamous cell carcinoma: our experience.

作者信息

Simonacci Francesco, Bertozzi Nicolò, Grieco Michele Pio, Grignaffini Eugenio, Raposio Edoardo

机构信息

Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy and the Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy..

出版信息

Acta Biomed. 2018 Jun 7;89(2):242-248. doi: 10.23750/abm.v89i2.6189.

Abstract

INTRODUCTION

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, with an excellent prognosis after surgical removal. However, nodal metastasis are present in about 5% of cases and the death rate is about 2%.

PRESENTATION OF CASE

The aim of this study is to report our experience about the surgical treatment of cSCC at the Cutaneous, Regenerative, Mininvasive and Plastic Surgery Unit, University of Parma, Italy, between January 2014 and February 2016. We statistically analyzed the group of patients regarding the average age, gender, localization and size of the lesions. The surgical margins of the excisions are studied and we report the results obtained after a follow up of 3 to 25 months.

DISCUSSION

Between January 2014 and February 2016 in our Cutaneous, Regenerative, Mininvasive and Plastic Surgery Unit, we removed 36 squamous cell carcinomas, including 11 cSCCs in situ. The average annual incidence of squamous cell carcinoma in northeast of Italy is about 28,9  cases per 100,000 individuals.The number of cSCCs that we removed is lower than the Italian average. In our opinion, this is due to an increase in the early diagnosis of precancerous lesions and their medical or surgical treatment. This reduces the incidence of squamous cell carcinomas developing from precancerous lesions.

CONCLUSION

The excision of cutaneous squamous cell carcinoma should be undertaken with a safety margin of at least 0.9 mm to minimize recurrence and metastasis.

摘要

引言

皮肤鳞状细胞癌(cSCC)是第二常见的皮肤癌,手术切除后预后良好。然而,约5%的病例存在淋巴结转移,死亡率约为2%。

病例介绍

本研究的目的是报告我们于2014年1月至2016年2月在意大利帕尔马大学皮肤、再生、微创和整形手术科对cSCC进行手术治疗的经验。我们对患者组的平均年龄、性别、病变部位和大小进行了统计分析。研究了切除的手术切缘,并报告了3至25个月随访后获得的结果。

讨论

2014年1月至2016年2月期间,在我们的皮肤、再生、微创和整形手术科,我们切除了36例鳞状细胞癌,其中包括11例原位cSCC。意大利东北部鳞状细胞癌的年平均发病率约为每10万人28.9例。我们切除的cSCC数量低于意大利平均水平。我们认为,这是由于癌前病变的早期诊断及其药物或手术治疗有所增加。这降低了由癌前病变发展而来的鳞状细胞癌的发病率。

结论

皮肤鳞状细胞癌的切除应采用至少0.9毫米的安全切缘,以尽量减少复发和转移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1598/6179017/b6867a82f321/ACTA-89-242-g003.jpg

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