J Korean Bone Joint Tumor Soc.  2012 Jun;18(1):7-13. 10.5292/jkbjts.2012.18.1.7.

Treatment of Squamous Cell Carcinoma in Extremity & Trunk

• Shin DS
• Kim BJ

• KMID: 1438399
• DOI: http://doi.org/10.5292/jkbjts.2012.18.1.7

Abstract

PURPOSE
The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma.
MATERIALS AND METHODS
From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared.
RESULTS
The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision.
CONCLUSION
In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Keyword

squamous cell carcinoma; treatment method; survival rate; prognostic factor

MeSH Terms

Amputation
Carcinoma, Squamous Cell
Extremities
Female
Follow-Up Studies
Humans
Male
Neoplasm Metastasis
Recurrence
Skin
Survival Rate
Transplants

Figure

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  Figure 1 (A) Forty one-year old male got an open wound on his left buttock 5 years ago, and that was not healed so far. It was diagnosed as squamous cell carcinoma at a local clinic. (B) Wide excision was done. (C) Local transposition flap on left thigh, meshed skin graft was done.

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  Figure 2 (A) Fifty year-old male had suffered from post-burn scar contracture from right axilla to forearm, and marjolin's ulcer of right forearm since he got burned 40 years ago. They were diagnosed as squamous cell carcinoma at a dermatologist's office. (B) Above-elbow amputation, and release of burn-scar contracture on right axilla was done. (C) Skin graft was done.

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  Figure 3 Overall survival of whole 41 patients.

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  Figure 4 Kaplan-Meier graph for survival rate of the acral and proximal location of squamous cell carcinoma.

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  Figure 5 Kaplan-Meier graph for survival rate of the idiopathic and secondary cause of squamous cell carcinoma.

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  Figure 6 Kaplan-Meier graph for survival rate of the well-differentiated and moderately-differentiated grade of squamous cell carcinoma.

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  Figure 7 Kaplan-Meier graph for survival rate of the stage I and stage II of squamous cell carcinoma.

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  Figure 8 Surgical method showed significant difference on survival (p<0.01).

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  Figure 9 Kaplan-Meier graph for survival rate of the operation only and additional anticancer therapy.

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