Invasive squamous cell carcinoma of the skin: Defining a high-risk group
Invasive squamous cell carcinoma of the skin: Defining a high-risk group
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DOI：
10.1245/aso.2006.07.022
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发表时间：
2006-07-01
影响因子：
3.7
通讯作者：
Cormier, Janice N.
中科院分区：
文献类型：
--
作者：
Mullen, John T.;Feng, Lei;Cormier, Janice N.
背景：与更常见的非侵袭性形式不同，皮肤侵袭性鳞状细胞癌（SCC）具有生物侵袭性，并且容易复发。本研究的目的是确定与侵袭性鳞状细胞癌患者结局相关的临床病理预后因素，以确定高危人群。方法：我们回顾性回顾了过去 10 年在三级癌症中心接受手术治疗的躯干或四肢侵袭性皮肤鳞状细胞癌患者的记录。我们检查了发病模式、所有已知的临床和组织学复发危险因素及其与生存的关系。结果：确定了 136 名患者，其中 102 名 (74%) 为男性。表现模式包括原发性（n = 91）、局部复发性（n = 16）、区域淋巴结（n = 24）和远处（n = 5）疾病。单变量分析确定低分化癌（风险比 [HR] = 2.92，P = .016）、疤痕癌（HR = 3.12，P = .008）、肿瘤大小 > 2 cm（HR = 3.79，P = .006）和区域淋巴结疾病（HR = 5.77，P < .0001）是复发或死亡的重要危险因素。然而，在多变量分析中，仅发现就诊时的区域淋巴结疾病（HR = 7.64，P < .0001）具有显着性。结论：侵袭性 SCC 转移至区域淋巴结的患者构成了复发和死亡高风险组。此类患者应考虑进行辅助治疗试验。
Background: Unlike its more common non-invasive form, invasive squamous cell carcinoma (SCC) of the skin can be biologically aggressive and is prone to recur. The objectives of this study were to identify relevant clinicopathologic prognostic factors associated with the outcomes of patients with invasive SCC in order to define a high-risk group.Methods: We retrospectively reviewed the records of patients with invasive cutaneous SCC of the trunk or extremities who received surgical treatment at a tertiary care cancer center over the past 10 years. We examined the patterns of presentation, all known clinical and histological risk factors for recurrence, and their association with survival.Results: 136 patients were identified, of whom 102 (74%) were male. Patterns of presentation included primary (n = 91), locally recurrent (n = 16), regional nodal (n = 24), and distant (n = 5) disease. Univariate analysis identified poorly differentiated carcinomas (hazard ratio [HR] = 2.92, P = .016), scar carcinomas (HR = 3.12, P = .008), tumor size > 2 cm (HR = 3.79, P = .006), and regional nodal disease (HR = 5.77, P < .0001) as significant risk factors for recurrence or death. On multivariate analysis, however, only regional nodal disease at presentation (HR = 7.64, P < .0001) was found to be significant.Conclusions: Patients with invasive SCCs metastatic to regional nodes constitute a group at high risk for recurrence and death. Such patients should be considered for adjuvant therapy trials.