PDF(Pubmed)
Abstract：
The globally increasing incidence of cutaneous malignancies leads, in parallel, to increasing numbers of locally advanced skin cancer resulting in reconstructive surgery. Reasons for locally advanced skin cancer may be a patient\'s neglect or aggressive tumor growth, such as desmoplastic growth or perineural invasion. This study investigates characteristics of cutaneous malignancies requiring microsurgical reconstruction with the aim of identifying possible pitfalls and improving diagnostic and therapeutic processes. A retrospective data analysis from 2015 to 2020 was conducted. Seventeen patients (n = 17) were included. The mean age at reconstructive surgery was 68.5 (±13) years. The majority of patients (14/17, 82%) presented with recurrent skin cancer. The most common histological entity was squamous cell carcinoma (10/17, 59%). All neoplasms showed at least one of the following histopathological characteristics: desmoplastic growth (12/17, 71%), perineural invasion (6/17, 35%), or tumor thickness of at least 6 mm (9/17, 53%). The mean number of surgical resections until cancer-free resection margins (R0) were achieved was 2.4 (±0.7). The local recurrence rate and the rate of distant metastases were 36%. Identified high-risk neoplastic characteristics, such as desmoplastic growth, perineural invasion, and a tumor depth of at least 6 mm, require a more extensive surgical treatment without concerns about defect size.
摘要：
全球增加的皮肤恶性肿瘤的发病率导致，并行,导致重建手术的局部晚期皮肤癌数量增加。局部晚期皮肤癌的原因可能是患者的忽视或肿瘤的侵袭性生长，如纤维增生性生长或神经周浸润。这项研究调查了需要显微外科手术重建的皮肤恶性肿瘤的特征，目的是确定可能的陷阱并改善诊断和治疗过程。对2015年至2020年的数据进行回顾性分析。包括17名患者（n=17）。重建手术的平均年龄为68.5（±13）岁。大多数患者（14/17，82%）出现复发性皮肤癌。最常见的组织学实体是鳞状细胞癌（10/17，59％）。所有肿瘤均表现出以下组织病理学特征中的至少一种：促纤维化生长（12/17，71％），神经周浸润（6/17，35%），或肿瘤厚度至少6毫米（9/17，53％）。直到达到无癌切除边缘（R0）的平均手术切除次数为2.4（±0.7）。局部复发率和远处转移率为36％。确定的高危肿瘤特征，比如去可塑性生长，神经周浸润,肿瘤深度至少为6毫米，需要更广泛的手术治疗，而无需担心缺损的大小。
