皮肤鳞状细胞癌的外科治疗

Surgical treatment for cutaneous squamous cell carcinoma

目的探讨皮肤鳞状细胞癌的外科治疗方法及效果。方法收集1981年12月至2011年12月鳞状细胞癌105例,其中手术治疗101例。切除病灶后,根据创面不同部位、大小、深度,选择任意皮瓣、肌皮瓣或皮片修复创面;创面位于面部及关节部位采用分区植皮方法。结果病灶切除后,移植皮片48例,任意皮瓣或肌皮瓣修复53例;随诊6个月以上85例,随诊5年以上52例,16例发生局部复发或远处转移,其中8例死亡,其余患者术区外形良好,局部无复发。结论皮肤鳞状细胞癌早期发现行完整手术切除仍然是最佳的治疗手段,对手术缺损可以采用整形美容方法修复,实现患者的生存时间和生活质量的提高。

Objective To explore the methods and efficacy of surgical treatment in cutaneous squamous cell carcinoma. Methods From December 1981 to December 2011, 105 cases of cutaneous squamous cell carcimoma were treated in our unit. The surgical excixion of wounds were repaired by local flap, myocutaneous flap and skin graft according to different location, size and depth. Zoning skin graft method was used for wounds on face and joint. Results Of 101 operated eases,48 cases were repaired by skin grafting and 53 cases repaired by local flap or myocutaneous flap. 85 patients were followed up over 6 months and 52 patients over 5 years. The results showed that 8 patients died, 16 patients appeared in local recurrence or distant metastasis and other patients kept well without recurrence. Conclusion Early detection and complete removal of focus might be an optimal therapeutic method for cuta- neous squamous cell earcimoma. Wound repair with plastic and cosmetic measures can improve survival and life quality of the patients.