Abstract：
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.
摘要：
皮肤鳞状细胞原位癌（SCCis）是一种预后良好的上皮内肿瘤。标准治疗包括手术和非手术干预。我们确定了用5％氟尿嘧啶乳膏（5-FU）局部治疗后，在Mohs显微手术（MMS）期间在冷冻切片上发现的SCC和残留SCC的清除率。所有MMS病例均为活检证实的浸润性鳞状细胞癌（SCC）。2017年1月至2024年2月，在哥伦比亚大学欧文医学中心（CUIMC）进行了回顾性图表审查，以确定接受局部5-FU作为主要治疗或辅助治疗（AT）治疗的SCCis患者MMS后残留SCCis用于侵入性SCC。纳入41例患者(80%为男性，70.1±11.8年）。主要治疗组平均随访时间为25.4±12.8个月,MMS后AT组22.5±11.1个月。在以局部5-FU作为主要疗法治疗的组中（n=28），27例患者（96.43%，95%置信区间:81.65-99.91%)达到完全清除率。一名患者在治疗后8个月复发。在MMS后辅助治疗组的患者中（n=13），12(92.3%间隙,95%置信区间63.97-99.81%)实现完全清除率。一名患者在治疗后8个月复发。这项研究发现，局部5-FU乳膏既可以有效地作为SCCis的主要疗法，也可以作为侵袭性SCCMMS后残留SCCis的辅助疗法。
