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手术治疗眶-睑部皮肤癌的肿瘤学和美容学结果:对 132 例患者的回顾性研究。

Oncological and aesthetic outcome following surgical management of orbito-palpebral skin cancers: A retrospective study of 132 patients.

机构信息

Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri-Mondor Hospital, AP-HP, Creteil, France.

Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri-Mondor Hospital, AP-HP, Creteil, France.

出版信息

J Craniomaxillofac Surg. 2019 Oct;47(10):1577-1582. doi: 10.1016/j.jcms.2019.07.015. Epub 2019 Jul 16.

DOI:10.1016/j.jcms.2019.07.015
PMID:31402206
Abstract

BACKGROUND

The incidence of facial skin cancers continues to rise, with major studies on their impacts still lacking in the literature. This study reports on the oncological and aesthetic results following surgical management of an orbito-palpebral skin cancer.

METHODS

This retrospective, monocentric study included patients treated for a non-melanoma skin cancer of the eyelid and orbit. Risk factors, location, histological type, invaded or insufficient margins, healing time, surgical management by excision and direct closure, skin graft or local flaps, self-evaluated aesthetics, and quality of life results were all compared.

RESULTS

The study included 132 patients operated for basal cell carcinoma (71.9%), squamous cell carcinoma (22.9%), or for another type (5.2%) between November 2011 and January 2017. Average tumor size was 9.6 ± 6.3 mm. Surgical management resulted in excision and open healing (9.1%), excision and direct closure (3.9%), skin graft (31.1%), local flap (21.9%), or another type of reconstruction (3.0%). Significant links between invaded or insufficient margins and basal cell type (OR = 3.37, p = 0.014), tumor size over 7 mm (OR = 2.7, p = 0.011), double location (OR = 8.44, p = 0.04), flap-based reconstruction (OR = 0.290, p = 0.02), and female gender (OR = 0.418, p = 0.034) were reported throughout our multivariate analysis.

CONCLUSIONS

This study brings out consequential information on factors linked with invaded or insufficient excision margins. Larger cohorts should evaluate the aesthetic outcomes in such a population.

摘要

背景

面部皮肤癌的发病率持续上升,但文献中仍缺乏对此类疾病影响的主要研究。本研究报告了经手术治疗的眶-眼睑皮肤癌的肿瘤学和美学结果。

方法

这是一项回顾性、单中心研究,纳入了 2011 年 11 月至 2017 年 1 月期间因眼睑和眼眶非黑色素瘤皮肤癌而接受治疗的患者。比较了危险因素、位置、组织学类型、切缘侵犯或不足、愈合时间、通过切除和直接闭合、植皮或局部皮瓣进行的手术治疗、自我评估的美学效果以及生活质量结果。

结果

该研究共纳入了 132 例基底细胞癌(71.9%)、鳞状细胞癌(22.9%)或其他类型(5.2%)患者。平均肿瘤大小为 9.6 ± 6.3mm。手术治疗结果为切除和开放愈合(9.1%)、切除和直接闭合(3.9%)、植皮(31.1%)、局部皮瓣(21.9%)或其他类型的重建(3.0%)。切缘侵犯或不足与基底细胞类型(OR = 3.37,p = 0.014)、肿瘤大小>7mm(OR = 2.7,p = 0.011)、双部位(OR = 8.44,p = 0.04)、皮瓣重建(OR = 0.290,p = 0.02)和女性(OR = 0.418,p = 0.034)之间存在显著关联。

结论

本研究提供了与切缘侵犯或不足相关的因素的重要信息。更大的队列研究应评估此类人群的美学效果。

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