背景:皮肤鳞状细胞癌(cSCC)是全球最常见的皮肤癌之一。由于日晒和寿命的不断增加,CSCC在全球范围内不断增加。我们研究的目的是确定导致局部和区域复发的特定风险因素,确定患者的生存率,并确定cSCC管理的最佳实践。
方法:本研究回顾性分析了2007年1月至2016年12月连续就诊的945例患者的1197例头颈部cSCCs。对患者进行至少18个月的随访。
结果:共有29例患者(3%)发生局部区域复发(26例局部,一个区域,和两个地方和区域),中位复发时间为25(范围,1-81)个月。平均随访为32(范围,5-90)个月。治疗方式(p=0.027),侵入深度(p<0.001),直径>20毫米(p<0.001),性别(p=0.022),组织学分化(p<0.001),病变部位(p<0.001),神经周和血管内浸润(p<0.001),阳性淋巴结病(p=0.021),免疫抑制(p<0.001),和治疗史(p=0.008)被证明是局部区域复发的有力预测因子。诊断后的一年和五年,95.6%和59.9%的患者无复发,分别。复发的中位生存时间为2.6年。
结论:我们的研究通过分析来自cSCCs管理的大型连续队列的数据来确定复发的预后指标。
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers worldwide. Due to the ever-increasing sun exposure and life expectancy, cSCCs are increasing worldwide. The aim of our study was to identify specific risk factors leading to local and regional recurrences, determine patients\' survival rates, and identify best practices for the management of cSCC.
METHODS: This study retrospectively analyzed 1197 head and neck cSCCs in 945 patients who consecutively presented to the clinics from January 2007 to December 2016. Patients were followed up for a minimum of 18 months.
RESULTS: A total of 29 patients (3%) developed loco-regional recurrences (26 local, one regional, and two both local and regional) with a median time to recurrence of 25 (range, 1-81) months. The mean follow-up was 32 (range, 5-90) months. Treatment modality (p=0.027), depth of invasion (p<0.001), diameter > 20 mm (p<0.001), gender (p=0.022), histological differentiation (p<0.001), site of the lesion (p<0.001), perineural and intravascular invasion (p<0.001), positive lymphadenopathy (p=0.021), immunosuppression (p<0.001), and history of treatment (p=0.008) proved to be strong predictors for loco-regional recurrences. At one and five years after diagnosis, 95.6% and 59.9% of all patients were recurrence-free, respectively. The median survival time from recurrence was 2.6 years.
CONCLUSIONS: Our study identifies prognostic indicators for reoccurrence by analyzing data from a large continuous cohort in the management of cSCCs.