Nemer Kathleen M, Bauman Tyler M, Laurin Council M, Hurst Eva A
Division of Dermatology, Washington University School of Medicine, St. Louis, MO, United States.
Int J Womens Dermatol. 2019 Nov 7;6(2):99-101. doi: 10.1016/j.ijwd.2019.10.005. eCollection 2020 Mar.
The risk of squamous cell carcinoma (SCC) is increased in solid organ transplant recipients (OTRs), and preferential treatment modalities vary among clinicians.
The purpose of this study was to survey dermatologists regarding practice patterns for electrodesiccation and curettage (EDC) of SCC in OTRs and nontransplant patients.
An 18-question survey was sent to dermatologist members of the International Transplant Skin Cancer Collaborative, Association of Professors of Dermatology, and American College of Mohs Surgery. Differences in EDC practice patterns for treatment of SCC in OTRs and nontransplant patients were evaluated.
Dermatologists in this study ( = 227) were more likely to treat SCC with EDC in nontransplant patients (67.4%) than in OTRs (48.0%; P = .0003).Dermatologists who perform EDC in both groups ( = 108) were unlikely to use EDC on the H-zone of the face; they were more likely to EDC tumors on non-H-zone areas of the face and neck in nontransplant patients compared to OTRs ( = .0007). Dermatologists were more likely to use EDC over surgery in nontransplant patients compared to OTRs with the following demographics: dementia or psychiatric disease ( = .04), multiple medical comorbidities ( = .03), or anticoagulation medications ( = .02).
In OTRs with SCC, 48% of clinicians would consider EDC. The main factors that affect the decision to perform EDC include tumor location and patient comorbidities.
实体器官移植受者(OTR)发生鳞状细胞癌(SCC)的风险增加,且不同临床医生的优先治疗方式存在差异。
本研究旨在调查皮肤科医生对OTR和非移植患者中SCC进行电干燥刮除术(EDC)的实践模式。
向国际移植皮肤癌协作组、皮肤科教授协会和美国莫氏外科学会的皮肤科医生成员发送了一份包含18个问题的调查问卷。评估了OTR和非移植患者中SCC的EDC治疗实践模式的差异。
本研究中的皮肤科医生(n = 227)在非移植患者中(67.4%)比在OTR中(48.0%)更倾向于用EDC治疗SCC(P = 0.0003)。在两组中都进行EDC的皮肤科医生(n = 108)不太可能对面部H区使用EDC;与OTR相比,他们在非移植患者的面部和颈部非H区更倾向于对肿瘤进行EDC(P = 0.0007)。与具有以下人口统计学特征的OTR相比,皮肤科医生在非移植患者中更倾向于使用EDC而非手术:痴呆或精神疾病(P = 0.04)、多种内科合并症(P = 0.03)或抗凝药物治疗(P = 0.02)。
在患有SCC的OTR中,48%的临床医生会考虑EDC。影响进行EDC决策的主要因素包括肿瘤位置和患者合并症。