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Department of Oncology and radiotherapy, University of Turku and Turku University Hospital, FIN-20520 Turku, Finland.
Acta Derm Venereol. 2022 Apr 8;102:adv00693. doi: 10.2340/actadv.v102.2073.
Most cases of keratinocyte cancer can be treated effectively with surgery. However, survival is reduced in patients with advanced disease. This retrospective cohort study evaluated overall survival of patients with invasive keratinocyte cancers, and high-risk features for progression of the disease and mortality in Finnish patients in a real-world setting. A total of 43,143 patients with keratinocyte cancer types of basal cell carcinoma and 10,380 with cutaneous squamous cell carcinoma were identified nationwide. More detailed patient records were available for a subset of patients (basal cell carcinoma n = 5,020 and cutaneous squamous cell carcinoma n = 1,482) from a regional database. Fifty percent of patients with advanced cutaneous squamous cell carcinoma died approximately 4.5 years after diagnosis. Multivariable models suggested that risk factors for keratinocyte cancer progression were male sex, presence of comorbidities, immunosuppression, and pre-cancerous lesions, while risk factors for disease-specific mortality were advanced disease stage with immunosuppression, other malignancies, and consecutive surgical excisions. These results suggest that identifying patient and tumour factors associated with poor disease outcome could be important when determining appropriate treatment and follow-up; however, further studies are necessary.
大多数角化细胞癌病例可以通过手术有效治疗。然而，晚期疾病患者的生存率降低。本回顾性队列研究评估了芬兰患者在真实环境中侵袭性角化细胞癌的总生存率，以及疾病进展和死亡率的高危特征。在全国范围内确定了 43143 例基底细胞癌和 10380 例皮肤鳞状细胞癌的角化细胞癌患者。从一个区域数据库中，有一小部分患者（基底细胞癌 n=5020 和皮肤鳞状细胞癌 n=1482）有更详细的患者记录。大约 4.5 年后，50%的晚期皮肤鳞状细胞癌患者死亡。多变量模型表明，角化细胞癌进展的危险因素是男性、合并症、免疫抑制和癌前病变，而疾病特异性死亡率的危险因素是免疫抑制、其他恶性肿瘤和连续手术切除的晚期疾病阶段。这些结果表明，当确定适当的治疗和随访时，确定与不良疾病结局相关的患者和肿瘤因素可能很重要；然而，还需要进一步的研究。
