ABSTRACT
OBJECTIVE: To analyze retrospectively a series of cases culminating in amputation for advanced squamous cell carcinoma. METHODS: We studied eight patients with histologically confirmed squamous cell carcinoma of the skin that had limbs amputated by tumor invasion at our institution between 2005 and 2008. We evaluated the histological factors and the institutional and psychosocial factors that contributed to this unfavorable outcome. RESULTS: The mean age at diagnosis was 63 years, 37.5% of patients (three patients) had a history of abusive and continuous exposure to sunlight and six (75%) patients had other risk factors for SCC of the skin. Seven patients were diagnosed when the tumor was already larger than 2cm, and it required a large period of time (6.7 years on average) between the onset of the initial lesion and the correct histopathological diagnosis of locally advanced tumor. CONCLUSION: The unfavorable outcome (amputation) in patients with squamous cell carcinoma may be associated with aggressiveness of cancer and related comorbidities, and may also be influenced by factors such as access to public health, quality of care and patient's relationship with the disease.
Subject(s)
Amputation, Surgical , Carcinoma, Squamous Cell/surgery , Leg , Skin Neoplasms/surgery , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
OBJETIVO: Analisar retrospectivamente uma série de casos que culminaram em amputação por carcinoma escamocelular avançado. MÉTODOS: Foram estudados oito pacientes com diagnóstico histológico de carcinoma escamocelular de pele que tiveram membros amputados por invasão tumoral, em nossa Instituição entre 2005 e 2008. Foram avaliados: fatores histológicos, institucionais e psicossociais que contribuíram para este desfecho desfavorável. RESULTADOS: A média de idade ao diagnóstico foi 63 anos; 37,5% dos pacientes (três pacientes) tinham exposição abusiva e contínua aos raios solares, e seis (75%) pacientes tinham outros fatores de risco para CEC de pele. Sete pacientes foram diagnosticados quando o tumor já era maior que 2cm, e foi necessário um período grande de tempo (6,7 anos em média) entre o aparecimento da lesão inicial e o diagnóstico histopatológico correto do tumor localmente avançado. CONCLUSÃO: O desfecho desfavorável (amputação) nos pacientes portadores de carcinoma espinocelular pode estar associado à agressividade da neoplasia e às comorbidades relacionadas, podendo ainda sofrer influência de fatores como acesso à saúde pública, qualidade da assistência médica e relação do paciente com a doença.
OBJECTIVE: To analyze retrospectively a series of cases culminating in amputation for advanced squamous cell carcinoma. METHODS: We studied eight patients with histologically confirmed squamous cell carcinoma of the skin that had limbs amputated by tumor invasion at our institution between 2005 and 2008. We evaluated the histological factors and the institutional and psychosocial factors that contributed to this unfavorable outcome. RESULTS: The mean age at diagnosis was 63 years, 37.5% of patients (three patients) had a history of abusive and continuous exposure to sunlight and six (75%) patients had other risk factors for SCC of the skin. Seven patients were diagnosed when the tumor was already larger than 2cm, and it required a large period of time (6.7 years on average) between the onset of the initial lesion and the correct histopathological diagnosis of locally advanced tumor. CONCLUSION: The unfavorable outcome (amputation) in patients with squamous cell carcinoma may be associated with aggressiveness of cancer and related comorbidities, and may also be influenced by factors such as access to public health, quality of care and patient's relationship with the disease.