Surgical Management of Facial Nonmelanoma Skin Cancer

手術治療顏面非黑色素瘤皮膚癌

張建仁(Chien-Jen Chang) ； 蕭順裕(Shun-Yu Hsiao) ； 張庭瑋(Ting-Wei Chang) ； 謝雅如(Ya-Ju Hsieh) ； 吳南霖(Nan-Lin Wu) ； 李幼華(Yu-Hua Li) ； 張國明(Kwok-Ming Chang) ； 黃佩雯(Pei-Wen Hung) ； 蔡永發(Yung-Fa Tsai)

《台灣癌症醫學雜誌》 28卷3期 (2012/09) Pp. 113-119

https://doi.org/10.6323/JoCRP.2012.28.3.2

摘要

背景：非黑色素瘤皮膚癌在皮膚癌中最為常見，其中基底細胞皮膚癌約佔80%，鱗狀細胞皮膚癌約佔20%。皮膚癌的治療方式包含：放射治療、冷凍療法、局部化學治療、刮除術、電燒法、傳統手術切除和莫氏顯微手術。治療非黑色素瘤皮膚癌最常使用的方法是手術切除。目的及目標：在我們的醫院裏，我們回顧顏面皮膚癌的病患以及它們的治療癒後。材料及方法：從2009年至2011年之間，我們分析31名顏面皮膚癌病人，包含病人的皮膚癌種類、手術細節及重建方式，並且分析了它們的存活率。結果：在整形外科及皮膚科所有治療顏面腫瘤病患中皮膚癌佔了1.6%（31/1893）。最常見的是基底細胞皮膚癌（BCC，67.7%），其次是鱗狀細胞皮膚癌（SCC，32.3%）。在手術治療後，有77.4%的病人因術後缺損過大需要施行重建手術。經過平均16.7個月的追蹤，有二名病患復發（6.5%）。所有病患的存活率是100%。結論：傳統手術切除腫瘤和立即施行皮瓣重建的治療模式，在可接受的復發率中是一種好的治療模式。

關鍵字

非黑色素瘤皮膚癌 ； 鱗狀細胞皮膚癌 ； 基底細胞皮膚癌

並列摘要

Background: Nonmelanoma skin cancer (NMSC) is the most common malignant facial tumor, and is comprised of basal cell carcinomas (approximately 80%), and squamous cell carcinomas (approximately 20%). The most frequently used method for treatment of facial nonmelanoma skin cancer is conventional surgical excision of the tumor. Our aim in this study was to review the cases of facial nonmelanoma skin malignancies and treatment outcomes of patients in our hospital. Methods: We retrospectively reviewed the medical records of 31 recruited patients with facial nonmelanoma skin cancers who were treated between 2009 and 2011. The profile data of these patients, details of surgery including procedures for primary tumor excision and reconstruction, as well as long-term outcomes were collected for analysis. Results: Facial nonmelanoma skin cancers constituted 1.6% (31/1893) of the new patients treated in our hospital's plastic surgery and dermatology departments. Basal cell carcinoma was the most common histological type (67.7%), followed by squamous cell carcinoma (32.3%). Reconstructive procedures were required in 77.4% of the patients, and local flaps were used for reconstruction in 17 cases (54.8%). For the most part, large post-resection defects were the predominant cause of these reconstructive procedures. During an average 16.7 months of follow-up, two patients had local recurrence (6.5%). Conclusions: Conventional surgical excision of facial nonmelanoma skin cancers with immediate reconstruction using a local flap constituted a good therapeutic modality with a low recurrence rate.

並列關鍵字

nonmelanoma skin cancer ； basal cell carcinoma ； squamous cell carcinoma