Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
Washington University School of Medicine, St. Louis, Missouri.
Dermatol Surg. 2020 Aug;46(8):1014-1020. doi: 10.1097/DSS.0000000000002336.
Cutaneous squamous cell carcinoma (SCC) of the hand presents a treatment challenge because of the anatomical complexity of this location. Immunosuppressed patients are disproportionately affected by cutaneous SCC. Existing data on SCC of the hand are primarily presented in the orthopedic literature, and may thus be affected by referral bias.
Characterization of epidemiology and treatment outcomes for hand versus nonhand cutaneous SCC in immunosuppressed versus immunocompetent patients, across all clinical departments.
Single-institution retrospective cohort study of cutaneous SCC evaluated over 3 years and hand SCC over an additional 5 years.
A cohort of 522 hand SCC cases (1,746 total SCC) was ascertained among 1,064 patients, of whom 175 were immunosuppressed. Occurrence on the hand was more common for SCC arising in immunosuppressed versus immunocompetent patients (38% vs 24% of cases respectively). Hand SCC cases demonstrated balanced laterality and comparable spectra of differentiation regardless of immunosuppression. No cases of hand SCC metastasis were observed over greater than 2 years' mean follow-up, and digital amputation was only required in approximately 1% of hand SCCs.
In our cohort, assessment of hand SCC across all clinical departments suggests more favorable prognosis than reflected in the previous literature.
手部皮肤鳞状细胞癌（SCC）的治疗具有挑战性，因为该部位的解剖结构复杂。免疫抑制患者更容易受到皮肤 SCC 的影响。手部 SCC 的现有数据主要在骨科文献中呈现，因此可能受到转诊偏倚的影响。
描述免疫抑制和免疫功能正常患者手部与非手部皮肤 SCC 的流行病学和治疗结果，涉及所有临床科室。
对 3 年内评估的皮肤 SCC 进行单机构回顾性队列研究，并对另外 5 年内的手部 SCC 进行评估。
在 1,064 名患者中确定了 522 例手部 SCC 病例（总计 1,746 例 SCC），其中 175 例为免疫抑制患者。与免疫功能正常患者相比，免疫抑制患者的 SCC 更常见于手部（分别为 38%和 24%的病例）。手部 SCC 病例无论是否存在免疫抑制，其左右侧分布均平衡，且分化谱相似。在超过 2 年的平均随访中，未观察到手部 SCC 转移的病例，且仅约 1%的手部 SCC 需要进行指端截断。
在我们的队列中，对所有临床科室的手部 SCC 评估表明，其预后优于既往文献中的报道。
