The Clinical Features And Postoperative Recurrence Of Skin Squamous Cell Carcinoma

Objective Most skin squamous cell carcinoma can be cured,but recurrence is a key factor affecting the therapeutic effect of squamous cell carcinoma,and the clinical treatment of squamous cell carcinoma of the skin facing the biggest problem,through the retrospective analysis of the clinical data of 118 cases of skin squamous cell carcinoma patients in this study,analysis of the impact of factors related to the recurrence of skin squamous cell carcinoma after operation,clinical treatment.Methods From January 2004 to November 2012 in Anhui Provincial Hospital from plastic surgery and pathological diagnosis of skin squamous cell carcinoma and effective follow-up of patients with a total of 118 patients were retrospectively analyzed gender,age of onset,duration,location,tumor size,preoperative ulceration,Surgical margin,first surgical margin status and postoperative adjuvant chemotherapy on recurrence after surgery,using SPSS16.0 statistical software for data analysis.First,variables are described and checked by normality.The quantitative data conforming to normal distribution are described by x±s.The non normal quantitative data are described by median(P25,P75),and qualitative data are described by constituent ratio.Secondly,univariate analysis was conducted,mainly counting data and chi square test.Finally,univariate analysis of variables with significant significance was included in multivariate analysis,and Logistic regression analysis was used for multivariate analysis.P<0.05 has statistical significance.Results :In 127 cases of skin squamous cell carcinoma,9 cases(7.09%)were lost to follow-up.118 patients were followed up after effective exclusion,106 cases of survival in 5 years(89.83%);12 cases of death(10.17%);38 cases were recurred after operation and 80 cases were not relapsed.Sex: 68 males(57.63%),50 women(42.37%);average age :(73.17 ± 7.69)years;average course of disease : 12months;Location of the disease: 89 cases of head and neck(75.42%),22 cases of limbs(18.64%),7 cases of trunk and perineum(5.93%);Average diameter of the lesion: 3cm;Whether the lesion is broken or not: 105 cases of rupture(88.98%),13 cases of no rupture(11.02%);Degree of pathological differentiation: 65 cases of high differentiation(55.08%),22 cases of middle and high differentiation(18.64%),17 cases of middle differentiation(14.40%),7 cases of middle and low differentiation(5.93%),7 cases of low differentiation(5.93%);Surgical margin :5mm38 case(32.20%),10mm47case(39.83%),20mm33case(27.97%);Treatment and repair methods: 18 cases of orthotopic suture after subcutaneous extension(15.25%),44 cases of flap transfer repair(37.28%),17 cases of flap transfer+ donor site grafting(14.41%),39 cases of free skin grafting(33.05%);Postoperative radiotherapy in 31 cases(26.27%),87 cases without postoperative radiotherapy(73.72%);Wound healing after operation:104 cases of good healing(88.13%),14 cases of malunion(11.86%);Postoperative pathological margin: Negative108cases(91.53%),10 cases of positive(8.47%);22 cases of lymph node metastasis(18.64%),96 cases of lymphatic metastasis without lymph node metastasis(81.36%).Tumor pathological classification,postoperative healing,lymph node metastasis and metastasis were associated with tumor recurrence.Logistic regression showed that OR > 1.6,P < 0.05.In addition,adjuvant chemotherapy factors such as age,gender,duration,location,tumor size,preoperative ulceration,surgical margin,for the first time after the operation,by single factor analysis and multi factors indicated that the recurrence is not clear,there was no statistically significant difference(P > 0.05).Conclusion: Surgical resection is the main method for treatment of skin squamous cell carcinoma,the incidence of male is higher,the onset age mainly concentrated in the elderly,60-79 years old is the peak,the tumor mainly occurs in the exposed parts of the body such as head and neck;Surgical margin,the first postoperative incision margin,tumor pathological grading,diagnosis,postoperative healing when there is no lymph node metastasis is related factors of recurrence of skin squamous cell carcinoma patients after surgery,5mm small surgical margin,low differentiation of tumor,postoperative healing,diagnosis of lymph node metastasis is affecting the skin squamous cell carcinoma patients with postoperative recurrence of independent risk factors,treatment should be considered comprehensively,before the operation should be fully estimated the nature and scope of the tumor no,The principle of complete resection of the tumor and insisting on no tumor operation was adopted during the operation,avoid surgical site infection,shorten the time of wound healing and reduce scar hyperplasia after surgery can reduce postoperative recurrence.