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Reappraisal of giant basal cell carcinoma: Clinical features and outcomes.

巨大基底细胞癌的再评价: 临床特征和结局。

  • 影响因子:1.32
  • DOI:10.1016/j.bjps.2019.06.029
  • 作者列表:"Oudit D","Pham H","Grecu T","Hodgson C","Grant ME","Rashed AA","Allan D","Green AC
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Giant basal cell carcinoma (GBCC) is a rare subgroup of basal cell carcinomas with a diameter of >5 cm. Current evidence about determining factors is conflicting, suggesting patient neglect, on the one hand, and biologically aggressive behaviour, on the other, with outcomes varying from clearance to death. We aimed to clarify the natural history of GBCC and its response to treatment. METHODS:We extracted information from clinical records of all patients with GBCC treated from 1998 to 2017 in a tertiary oncology hospital in northwest England. Associations between patient and tumour characteristics were investigated, and modes of treatment and outcomes were assessed. RESULTS:In the 20-year study period, 43 patients (median age 76 years; 23 (53%) female), 3 of whom had Gorlin syndrome, were treated for GBCCs. Median diameter was 6.3 cm, and median time to presentation was 5 years. Seven (16%) GBCCs arose from recurrent BCC, while the majority (84%) presented de novo. The size of GBCC was significantly correlated with delay in presentation (p = 0.03) but not with age or sex. Of 41 patients receiving definitive treatment, 19 GBCCs were treated by excision with ≤1 cm margin and none recurred during follow-up, compared with 10 recurrences of 23 treated with photodynamic therapy (PDT), and 1 of 7 recurred after radiotherapy. Two of 43 patients with GBCC (<5%) presented with extensive local invasion, one of whom also had distant metastases, and both died of the disease. CONCLUSION:The majority of GBCCs are not clinically aggressive and respond to conservative surgical treatment with a low risk of recurrence.

摘要

背景: 巨大基底细胞癌 (GBCC) 是一种罕见的基底细胞癌亚群,直径> 5 cm。目前关于决定因素的证据相互矛盾,一方面提示患者忽视,另一方面提示生物学攻击行为,结果从清除到死亡不等。我们旨在阐明GBCC的自然史及其对治疗的反应。 方法: 我们从英格兰西北部一家三级肿瘤医院 1998 年至 2017 年治疗的所有GBCC患者的临床记录中提取信息。研究了患者和肿瘤特征之间的关联,并评估了治疗模式和结果。 结果: 在 20 年的研究期间,4 3 例患者 (中位年龄 76 岁; 2 3 例 (5 3%) 女性),其中 3 例发生Gorlin综合征,接受过GBCCs治疗。中位直径为 6.3 cm,中位就诊时间为 5 年。7 例 (16%) GBCCs来自复发性BCC,而大多数 (84%) 呈现从头开始。GBCC的大小与就诊延迟显著相关 (p = 0.03),而与年龄或性别无关。在 4 1 例接受确定性治疗的患者中,1 9 例GBCCs采用切缘 ≤ 1 cm的切除治疗,随访期间无复发。比较 23 例光动力疗法 (PDT) 治疗后 1 0 例复发,7 例放疗后 1 例复发。43 例GBCC患者中有 2 例 (<5%) 表现为广泛的局部浸润,其中 1 例也有远处转移,均死于该病。 结论: 大多数GBCCs在临床上没有侵袭性,对保守手术治疗有反应,复发风险低。

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影响因子:0.96
发表时间:2020-01-01
DOI:10.1097/DAD.0000000000001459
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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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