Abstract：
OBJECTIVE: Traditionally, locally advanced scalp malignancies have been managed through composite, full-thickness calvarial resection. The aim of this study is to explore the oncologic outcomes of partial calvarial resection for locally invasive scalp malignancies without medullary space invasion, employing a burr-down approach.
METHODS: Retrospective case series.
METHODS: Tertiary referral center.
METHODS: This study analyzed records of 26 adult patients diagnosed with scalp cancer that spread to the calvarial region. Data collected included demographics, medical history, adjuvant therapy details, imaging, surgical outcomes, and postoperative oncological results.
RESULTS: 26 patients with cancerous scalp lesions necessitating calvarial resection for deep margin control were identified in 22 men and 4 women. Mean age at diagnosis was 72.7 years. The most common histopathological diagnosis was Squamous cell carcinoma (n = 16). Partial removal of the calvarial lesions was achieved in all patients without any intraoperative complications. Twelve patients received adjuvant therapy consisting of the following modalities: radiation (6), chemotherapy (1), immunotherapy (1), a combination of immunotherapy and radiation (2), and a combination of chemotherapy and radiotherapy (2). There was a total of 7 recurrences: local (n = 3,11.5 %), regional (n = 3,11.5 %), distal (n = 1,3.8 %). Long term local control was achieved in (n = 23,88.4 %) of patients. The mean time of follow-up was 19.1 months, and the mean time to recurrence was 15.1 months.
CONCLUSIONS: Partial calvarial resection represents a viable, safe, and effective surgical technique for cancerous tissue removal, reducing risks associated with full thickness calvarial resection, and enhancing soft tissue healing when compared to the established gold standard.
METHODS: Retrospective case series.
METHODS: Tertiary referral center.
METHODS: This study analyzed records of 26 adult patients diagnosed with scalp cancer that spread to the calvarial region. Data collected included demographics, medical history, adjuvant therapy details, imaging, surgical outcomes, and postoperative oncological results.
RESULTS: 26 patients with cancerous scalp lesions necessitating calvarial resection for deep margin control were identified in 22 men and 4 women. Mean age at diagnosis was 72.7 years. The most common histopathological diagnosis was Squamous cell carcinoma (n = 16). Partial removal of the calvarial lesions was achieved in all patients without any intraoperative complications. Twelve patients received adjuvant therapy consisting of the following modalities: radiation (6), chemotherapy (1), immunotherapy (1), a combination of immunotherapy and radiation (2), and a combination of chemotherapy and radiotherapy (2). There was a total of 7 recurrences: local (n = 3,11.5 %), regional (n = 3,11.5 %), distal (n = 1,3.8 %). Long term local control was achieved in (n = 23,88.4 %) of patients. The mean time of follow-up was 19.1 months, and the mean time to recurrence was 15.1 months.
CONCLUSIONS: Partial calvarial resection represents a viable, safe, and effective surgical technique for cancerous tissue removal, reducing risks associated with full thickness calvarial resection, and enhancing soft tissue healing when compared to the established gold standard.
摘要：
目标：传统上，局部晚期头皮恶性肿瘤已通过复合治疗，全厚度颅骨切除术。这项研究的目的是探讨部分颅骨切除术治疗局部浸润性头皮恶性肿瘤的肿瘤学结果，采用去毛刺的方法。
方法：回顾性病例系列。
方法：三级转诊中心。
方法：本研究分析了26例诊断为头皮癌并扩散到颅骨区域的成年患者的记录。收集的数据包括人口统计，病史,辅助治疗细节，成像,手术结果,和术后肿瘤结果。
结果：在22名男性和4名女性中发现了26例需要切除颅骨以控制深部边缘的癌性头皮病变患者。诊断时的平均年龄为72.7岁。最常见的组织病理学诊断是鳞状细胞癌（n=16）。所有患者均部分切除了颅骨病变，没有任何术中并发症。12名患者接受了包括以下方式的辅助治疗：放射（6），化疗（1），免疫疗法（1），免疫疗法和放射疗法的结合（2），以及化疗和放疗的组合（2）。共有7次复发：局部(n=3，11.5%)，区域(n=3,11.5%)，远端（n=1,3.8％）。（n=23,88.4％）的患者实现了长期局部控制。平均随访时间为19.1个月,平均复发时间为15.1个月.
结论：部分颅骨切除术代表可行的，安全,和有效的癌组织切除手术技术，降低与全厚度颅骨切除相关的风险，与既定的黄金标准相比，增强了软组织的愈合。
方法：回顾性病例系列。
方法：三级转诊中心。
方法：本研究分析了26例诊断为头皮癌并扩散到颅骨区域的成年患者的记录。收集的数据包括人口统计，病史,辅助治疗细节，成像,手术结果,和术后肿瘤结果。
结果：在22名男性和4名女性中发现了26例需要切除颅骨以控制深部边缘的癌性头皮病变患者。诊断时的平均年龄为72.7岁。最常见的组织病理学诊断是鳞状细胞癌（n=16）。所有患者均部分切除了颅骨病变，没有任何术中并发症。12名患者接受了包括以下方式的辅助治疗：放射（6），化疗（1），免疫疗法（1），免疫疗法和放射疗法的结合（2），以及化疗和放疗的组合（2）。共有7次复发：局部(n=3，11.5%)，区域(n=3,11.5%)，远端（n=1,3.8％）。（n=23,88.4％）的患者实现了长期局部控制。平均随访时间为19.1个月,平均复发时间为15.1个月.
结论：部分颅骨切除术代表可行的，安全,和有效的癌组织切除手术技术，降低与全厚度颅骨切除相关的风险，与既定的黄金标准相比，增强了软组织的愈合。
