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Long-term clinical outcomes of patients with invasive cutaneous squamous cell carcinoma treated with Mohs micrographic surgery: A 5-year, multicenter, prospective cohort study.

Mohs显微外科手术治疗侵袭性皮肤鳞状细胞癌患者的长期临床结局: 一项 5 年、多中心、前瞻性队列研究。

  • 影响因子:2.93
  • DOI:10.1016/j.jaad.2019.06.1303
  • 作者列表:"Tschetter AJ","Campoli MR","Zitelli JA","Brodland DG
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Outcomes for patients with cutaneous squamous cell carcinoma (CSCC) treated with Mohs micrographic surgery (MS) in the United States have never been prospectively defined. Risk factors as they relate to outcomes are primarily derived from single-institution, retrospective data without regard for treatment modality. The American Joint Committee on Cancer Staging Manual, Eighth Edition, and the Brigham and Women's Hospital T staging systems have not been prospectively validated. OBJECTIVE:To prospectively quantify outcomes by T stage and verify historically high-risk features as they pertain to outcomes in MS-treated CSCC. METHODS:A 5-year, prospective, multicenter analysis of patients undergoing MS for invasive CSCC was conducted. RESULTS:The study enrolled 647 patients with 745 tumors. The 5-year local recurrence (LR)-free survival, nodal metastasis (NM)-free survival, and disease-specific survival were 99.3%, 99.2%, and 99.4%, respectively. Both staging systems were predictive of NM, disease-specific death, and all-cause death; neither was predictive of LR. Although Breslow depth was statistically associated with LR, NM, and disease-specific death, incidental perineural invasion was not. LIMITATIONS:The Brigham and Women's Hospital and the American Joint Committee on Cancer Staging Manual, Eighth Edition T staging systems were published after study enrollment, therefore T stages were retrospectively applied using the prospectively collected data. CONCLUSION:MS is a highly effective treatment for CSCC and may mitigate factors typically considered high risk. Uniform reporting of Breslow depth should be considered in CSCC. The American Joint Committee on Cancer Staging Manual, Eighth Edition, and the Brigham and Women's Hospital staging system are useful prognosticators but are not predictive of LR after MS.

摘要

背景: 美国应用Mohs显微手术 (MS) 治疗的皮肤鳞状细胞癌 (CSCC) 患者的结局从未被前瞻性定义。与结局相关的危险因素主要来源于单机构的回顾性数据,不考虑治疗方式。T他美国加入t Commi t t ee on Cancer S t aging Manual,Eigh t h Edi t ion,与t他布里格姆妇女医院t al T s t老化sys t ems没有t被prospec t ively验证t ed. OBJEC T IVE:T o prospec t ively全t ify ou t过来T s t年龄核实他的t orically高危fea t措施作为t嘿每t可t o ou t进来MS-t rea t ed CSCC。 方法: 对因侵袭性CSCC接受MS的患者进行 5 年、前瞻性、多中心分析。 结果: 该研究纳入了 647 例患者,共 745 个肿瘤。5 年无局部复发 (LR) 生存率、无淋巴结转移 (NM) 生存率和疾病特异性生存率分别为 99.3% 、 99.2% 和 99.4%。两种分期系统均预测NM、疾病特异性死亡和全因死亡; 两者均未预测LR。虽然Breslow深度与LR、NM和疾病特异性死亡在统计学上相关,但偶发神经周围浸润没有。 LIMI T A T IONS:T he Brigham and Women 'S Hospi t al and t he American Join t Commi t t ee on Cancer S t aging Manual,eigh t h Edi t ion T s t aging sys t ems发表af t er s t udy enrollmen t,t因此T s t年龄re t rospec t ively采用t他prospec t ively collec t ed da t a. 结论: MS是CSCC的高效治疗方法,可缓解通常被认为是高风险的因素。CSCC应考虑Breslow深度的统一报告。美国癌症联合委员会分期手册第 8 版和Brigham和妇女医院分期系统是有用的预测指标,但不能预测MS后的LR。

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影响因子:0.96
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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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