Holmkvist K A, Roenigk R K
Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
J Am Acad Dermatol. 1998 Jun;38(6 Pt 1):960-6. doi: 10.1016/s0190-9622(98)70160-4.
Mohs micrographic surgery (MMS) is believed to be a highly effective treatment of squamous cell carcinoma (SCC) of the lip.
The goals of our study were to determine the long-term (5-year) outcome of patients treated with MMS for SCC of the lip and to identify factors associated with tumor recurrence.
Clinical and histopathologic data from 50 consecutive cases of SCC of the lip treated with MMS were retrospectively reviewed.
There were no tumor-related deaths or metastases. Forty-six patients (92%) remained free of disease. Four patients (8%) were diagnosed with SCC at the surgical site after MMS. Recurrent lesions tended to be superficial and occurred in the setting of severe actinic cheilitis. The average time to diagnosis after MMS was 2.5 years. All patients with recurrent disease were treated with further MMS and had successful results. No recurrences were seen among patients who received adjuvant treatment for actinic cheilitis with the carbon dioxide (CO2) laser, had clinical lesions 1 cm or less in diameter, or had post-MMS defects 2 cm or less in diameter.
MMS is highly effective for treating both primary and recurrent SCC of the lip. Treatment of coexisting actinic cheilitis may lower the risk for local recurrence after MMS.
莫氏显微外科手术（MMS）被认为是治疗唇部鳞状细胞癌（SCC）的一种高效方法。
我们研究的目的是确定接受MMS治疗唇部SCC患者的长期（5年）预后，并确定与肿瘤复发相关的因素。
回顾性分析50例连续接受MMS治疗的唇部SCC患者的临床和组织病理学数据。
无肿瘤相关死亡或转移。46例患者（92%）无疾病复发。4例患者（8%）在MMS术后手术部位被诊断为SCC。复发病变往往较表浅，且发生于严重光化性唇炎的情况下。MMS术后至诊断的平均时间为2.5年。所有复发患者均接受进一步MMS治疗，效果良好。接受二氧化碳（CO2）激光辅助治疗光化性唇炎、临床病变直径1 cm或更小、或MMS术后缺损直径2 cm或更小的患者未出现复发。
MMS对治疗唇部原发性和复发性SCC均非常有效。治疗并存的光化性唇炎可能会降低MMS术后局部复发的风险。
