Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University-Health Shreveport, Shreveport.
JAMA Otolaryngol Head Neck Surg. 2021 Jul 1;147(7):624-631. doi: 10.1001/jamaoto.2021.0760.
Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer and commonly affects the head and neck. Increasing regional reports of aggressive cases warrant an analysis of population-based trends of cSCC of the head and neck.
To assess demographic, clinical, and survival trends among patients with cSCC of the external lip.
DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, population-based cohort study of 15 171 cases of cSCC of the external lip registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Statistical analyses were conducted in October 2020.
The primary outcome was clinical characteristics (tumor site, stage, and tumor grade). Demographic characteristics, incidence, treatment characteristics, and survival outcomes were also assessed.
In total, 15 171 cases of cSCC were extracted from the SEER database (80.3% of patients were male, and 97.0% identified as being of White race/ethnicity). Incidence among male patients decreased from 4.4 to 0.8 per 100 000 during the study period, whereas the female patients' share cases increased from 8.4% in 1975 to 1979 to 26.1% by 2016. Cases increased in the US Pacific Coast and eastern regions, and along the 30° to 39° N latitudinal range, while decreasing in the southwestern region. Of 15 171 cases, 51.2% cases presented at stage I, and 96.2% were nonmetastatic. Cases of grade II and grade III tumors increased between 1975 and 2016. Five-year disease-specific survival remained stable at 95.9%; however, patients older than 75 years experienced worse disease-specific survival (93.2%) associated with decreasing survival trends among patients older than 85 years.
This population-based cohort study found that incidence of cSCC of the external lip decreased among men; however, cases increased along US coastal regions and in more northern US latitudes. Tumor grades were increasingly advanced, and patients older than 85 years should be given special prognosis and treatment consideration.
皮肤鳞状细胞癌（cSCC）是第二常见的非黑色素瘤皮肤癌，通常影响头颈部。越来越多的区域性侵袭性病例报告需要对头颈部 cSCC 的人群趋势进行分析。
评估外部唇 cSCC 患者的人口统计学、临床和生存趋势。
设计、地点和参与者：这是一项回顾性、基于人群的队列研究，纳入了 1975 年至 2016 年间在监测、流行病学和最终结果（SEER）数据库中登记的 15171 例外部唇 cSCC 病例。统计分析于 2020 年 10 月进行。
主要结局是临床特征（肿瘤部位、分期和肿瘤分级）。还评估了人口统计学特征、发病率、治疗特征和生存结局。
从 SEER 数据库中提取了 15171 例 cSCC（80.3%的患者为男性，97.0%为白人种族/民族）。在此研究期间，男性患者的发病率从 1975 年至 1979 年的每 100000 人 4.4 例降至 0.8 例，而女性患者的病例比例从 1975 年至 1979 年的 8.4%增加到 2016 年的 26.1%。病例在美国太平洋沿岸和东部地区以及 30°至 39°N 纬度范围内增加，而在西南部地区减少。在 15171 例病例中，51.2%的病例处于 I 期，96.2%的病例为非转移性。1975 年至 2016 年间，II 级和 III 级肿瘤的病例有所增加。5 年疾病特异性生存率保持稳定在 95.9%；然而，75 岁以上的患者预后较差（93.2%），85 岁以上患者的生存率呈下降趋势。
这项基于人群的队列研究发现，外部唇 cSCC 的男性发病率下降；然而，病例在美国沿海地区和更北的美国纬度范围内增加。肿瘤分级越来越高，85 岁以上的患者应给予特殊的预后和治疗考虑。
