Sayed Leela, Deodhar Avinash K, Agarwal Reena
Department of Plastic Surgery, University Hospitals of Leicester, Infirmary Square, Leicester LE1 5WW, United Kingdom.
JPRAS Open. 2019 Jan 9;20:43-58. doi: 10.1016/j.jpra.2019.01.001. eCollection 2019 Jun.
Squamous cell carcinoma (SCC) is one of the most common primary malignancies affecting the upper limb. A range of treatment options exist for its management; amputation being indicated under certain instances. This is the first comprehensive case series and review of the literature reporting outcomes following amputation of the affected region for treatment of upper extremity SCC We present a series of six patients with squamous cell carcinoma of the upper limb that required amputation alongside that of data from literature review. Patient demographics, risk factors, tumour characteristics and rates of recurrence, metastasis and mortality were recorded. A total of 45 patients with 49 histologically confirmed squamous cell carcinomas were identified from case series and literature review. Patients presenting with upper limb SCC were predominantly male and in their sixth decade of life. Mean follow up time was 30.5 months and the overall recurrence and metastatic rates were 8.2% and 14.3%, respectively. Mortality was 14.3% however only 6.1% was related to SCC metastasis. Rates of recurrence and metastasis are higher for SCCs affecting the hand as compared to other body sites. Furthermore, different regions of the hand appear to behave differently. SCC affecting the nail unit has a high recurrence and a low metastatic rate, whereas, SCC involving the palm and webspaces are aggressive and this is true despite amputation of the affected site.
鳞状细胞癌（SCC）是影响上肢的最常见原发性恶性肿瘤之一。其治疗有一系列选择；在某些情况下需要截肢。这是首例关于上肢SCC截肢治疗后结果的综合病例系列及文献综述。我们报告了一系列6例上肢鳞状细胞癌患者，他们需要截肢，并结合文献综述的数据。记录了患者的人口统计学特征、危险因素、肿瘤特征以及复发、转移和死亡率。通过病例系列和文献综述共确定了45例患者，其中49例经组织学确诊为鳞状细胞癌。上肢SCC患者以男性为主，年龄多在60岁左右。平均随访时间为30.5个月，总体复发率和转移率分别为8.2%和14.3%。死亡率为14.3%，但仅6.1%与SCC转移有关。与身体其他部位相比，手部SCC的复发率和转移率更高。此外，手部不同区域的表现似乎有所不同。影响甲单元的SCC复发率高，转移率低，而累及手掌和指蹼间隙的SCC具有侵袭性，尽管对受累部位进行了截肢，情况依然如此。
