Recurrence After Treatment of Nonmelanoma Skin Cancer A Prospective Cohort Study
Recurrence After Treatment of Nonmelanoma Skin Cancer A Prospective Cohort Study
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DOI：
10.1001/archdermatol.2011.109
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发表时间：
2011-05-01
影响因子：
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通讯作者：
Boscardin, John
中科院分区：
文献类型：
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作者：
Chren, Mary-Margaret;Torres, Jeanette S.;Boscardin, John
目的：确定原发性非黑色素瘤皮肤癌（NMSC）治疗后的长期肿瘤复发率。目前的数据还不足以让NMSC.Design治疗之间的循证选择：一个起始队列的前瞻性研究，观察治疗后的中位数为6.6年。护理提供了由皮肤科住院医师或主治医师。Patients：对比样本的所有495例患者616原发性NMSCs诊断于1999年和2000年，并与电干燥和刮宫（艾德&C），切除，或莫氏手术治疗。随访608例肿瘤（99%）。主要结果测量：肿瘤复发，由病历审查确定，通过临床检查验证。结果：诊断时的平均年龄为71岁，97%为男性。总体而言，127例肿瘤采用艾德&C治疗（20.9%）; 309例采用切除术（50.8%）; 172例采用Mohs手术（28.3%）。在研究过程中，21个肿瘤复发（3.5% [95%置信区间（CI），2.2%-5.2%]）：艾德&C后2例（1.6% [95% CI，0.2%-5.6%]），切除后13例结论：原发性骨髓间充质干细胞治疗后复发率低于5%。艾德&C后的复发率低于预期，莫氏手术后的复发率高于预期。这些发现可能与治疗组的复发风险有关。
Objective: To determine long-term tumor recurrence rates after treatment of primary nonmelanoma skin cancer (NMSC). Data are currently insufficient to permit evidence-based choices among treatments for NMSC.Design: Prospective study of an inception cohort observed for a median of 6.6 years after treatment.Setting: Dermatology clinic at a Veterans Affairs hospital. Care was provided by dermatology resident or attending physicians.Patients: Consecutive sample of all 495 patients with 616 primary NMSCs diagnosed in 1999 and 2000 and treated with electrodessication and curettage (ED&C), excision, or Mohs surgery. Follow-up was available for 608 tumors (99%).Main Outcome Measure: Tumor recurrence, deter-mined by medical record review, with validation by clinical examination.Results: The mean age at diagnosis was 71 years; 97% were men. Overall, 127 tumors were treated with ED&C (20.9%); 309 with excision (50.8%); and 172 with Mohs surgery (28.3%). Over the course of the study, 21 tumors recurred (3.5% [95% confidence interval (CI), 2.2%-5.2%]): 2 after ED&C (1.6% [95% CI, 0.2%-5.6%]), 13 after excision (4.2% [95% CI, 2.2%-7.1%]), and 6 after Mohs surgery (3.5% [95% CI, 1.3%-7.4%]).Conclusions: Recurrence of primary NMSC after treatment occurred in less than 5% of tumors. The recurrence rate after ED&C was lower than expected, and the recurrence rate after Mohs surgery was higher than expected. These findings may be related to the risk for recurrence in the treatment groups.