Ampil F L, Hardin J C, Peskind S P, Stucker F J
Department of Radiology, Louisiana State University School of Medicine, Shreveport.
J Oral Maxillofac Surg. 1995 Jan;53(1):34-8. doi: 10.1016/0278-2391(95)90496-4.
To review the management and outcome of skin cancer of the head and neck with perineural invasion, a relatively uncommon and complex condition, in nine patients treated between 1965 and 1991.
Seven patients had skin cancers that were larger than 2 cm. All lesions were moderately or poorly differentiated. Curative surgery was performed in all nine cases, with or without radiotherapy.
Local recurrence or regional disease appeared in three individuals; surgical salvage produced satisfactory results. At last follow-up (median, 45 months; range, 18 to 201 months), no one had developed intracranial or skull base metastasis; lung cancer was detected in one patient. The crude survival rate was 33% at 5 years and 22% at 10 years. The median survival was 25 months in patients who presented with neurologic symptoms and was 49 months in asymptomatic persons.
Although the prognosis in patients with skin cancer of the head and neck complicated by perineural invasion is expectedly poor, long-term disease-free survival is attainable with the use of aggressive therapy.
回顾1965年至1991年间接受治疗的9例头颈部皮肤癌伴神经周围侵犯患者的治疗情况及预后，这是一种相对罕见且复杂的病症。
7例患者的皮肤癌大于2厘米。所有病变均为中分化或低分化。9例患者均接受了根治性手术，部分联合放疗。
3例患者出现局部复发或区域病变；手术挽救取得了满意效果。在最后一次随访时（中位时间45个月；范围18至201个月），无人发生颅内或颅底转移；1例患者检测出肺癌。5年总生存率为33%，10年为22%。出现神经症状的患者中位生存期为25个月，无症状患者为49个月。
尽管头颈部皮肤癌伴神经周围侵犯患者的预后预期较差，但积极治疗可实现长期无病生存。
