Department of Dermatology, Columbia University Irving Medical Center, New York, USA.
Department of Biostatistics, Columbia University Mailman School of Public Health, Herbert Irving Pavilion, 12th Floor, New York, NY, 10032, USA.
Arch Dermatol Res. 2024 May 24;316(6):220. doi: 10.1007/s00403-024-02906-4.
Cutaneous squamous cell carcinoma in-situ (SCCis) is an intraepithelial tumor with a good prognosis. Standard treatment includes both surgical and non-surgical interventions. We determined the clearance rate for SCCis and residual SCCis identified on frozen section during Mohs micrographic surgery (MMS) after treatment with topical fluorouracil 5% cream (5-FU). All MMS cases were initiated for biopsy-proven invasive squamous cell carcinoma (SCC). A retrospective chart review was conducted from January 2017-February 2024 at Columbia University Irving Medical Center (CUIMC) to identify patients with SCCis who were treated with topical 5-FU as primary therapy or adjuvant therapy (AT) for residual SCCis post-MMS for invasive SCC. 41 patients were included (80% males, 70.1 ± 11.8 years). The average follow-up time for the primary therapy group was 25.4 ± 12.8 months, and for the post-MMS AT group 22.5 ± 11.1 months. In the group treated with topical 5-FU as primary therapy (n = 28), 27 patients (96.43%, 95% confidence interval: 81.65-99.91%) achieved complete clearance. One patient had recurrence at 8 months post-treatment. Of the patients in the post-MMS adjuvant treatment group (n = 13), 12 (92.3% clearance, 95% confidence interval 63.97-99.81%) achieved complete clearance. One patient had recurrence at 8 months post-treatment. This study found that topical 5-FU cream is effective as both primary therapy for SCCis and as adjuvant therapy for residual SCCis following MMS of invasive SCC.
原位皮肤鳞状细胞癌（SCCis）是一种上皮内肿瘤，预后良好。标准治疗包括手术和非手术干预。我们确定了在浸润性鳞状细胞癌（SCC）经 Mohs 显微外科手术（MMS）治疗后，使用 5%氟尿嘧啶乳膏（5-FU）治疗时，SCCis 和冷冻切片中残留 SCCis 的清除率。所有 MMS 病例均由经活检证实的浸润性鳞状细胞癌（SCC）开始。从 2017 年 1 月至 2024 年 2 月，在哥伦比亚大学欧文医学中心（CUIMC）进行了一项回顾性图表审查，以确定接受 5-FU 局部治疗作为原发性治疗或 MMS 后浸润性 SCC 残留 SCCis 的辅助治疗（AT）的 SCCis 患者。共纳入 41 例患者（男性 80%，70.1±11.8 岁）。原发性治疗组的平均随访时间为 25.4±12.8 个月，MMS 后 AT 组为 22.5±11.1 个月。在接受 5-FU 局部治疗作为原发性治疗的患者中（n=28），27 例（96.43%，95%置信区间：81.65-99.91%）完全清除。1 例患者在治疗后 8 个月复发。在 MMS 后辅助治疗组（n=13）中，12 例（92.3%的清除率，95%置信区间 63.97-99.81%）完全清除。1 例患者在治疗后 8 个月复发。这项研究发现，5-FU 乳膏局部治疗不仅可作为 SCCis 的原发性治疗，也可作为 MMS 治疗浸润性 SCC 后残留 SCCis 的辅助治疗。
