Clinicopathological features and related factors of postoperative recurrence of cutaneous squamous cell carcinoma / 中国医师杂志

ABSTRACT

Objective:To investigate the clinicopathological features and factors related to recurrence in patients with cutaneous squamous cell carcinoma (CSCC).Methods:The clinical and pathological data of 279 patients with CSCC diagnosed by histopathology in department of dermatology, plastic surgery, burns and oral and maxillofacial surgery of People′s Hospital of Xinjiang Uygur Autonomous Region from 2008 to 2019 were collected. They were divided into relapse group ( n=114) and non relapse group ( n=165) according to postoperative recurrence. Univariate and multivariate logistic analysis were used to analyze the related factors of CSCC recurrence. Results:Among 279 patients with CSCC surgery, the ratio of male to female was about 1.82∶1; the average age of onset (59.3±14.2)years, age ≥60 years (58.1%) was significantly higher; the average course of disease was 24 months; the incidence of exposed sites (88.2%) was significantly higher than that of non-exposed sites (11.8%); the degree of pathological differentiation was 182(65.2%) cases; postoperative wound healing: good 244 cases (87.5%), poor healing 35 cases (12.5%); first postoperative pathological margin: 239(85.7%) negative and 40(14.3%) positive; 60(21.5%) cases had lymph node metastasis occurred at the CSCC of diagnosis, and 219(78.5%) did not occur. Univariate analysis and multivariate logistic regression showed that the course of disease, the location of the disease, the healing of the postoperative area, the pathological condition of the first incision margin, and whether there was lymph node metastasis at the time of diagnosis were related to the recurrence of CSCC ( OR all >1.6). In addition, the correlation between gender, age, lesion length, preoperative skin ulceration, pathological differentiation, adjuvant radiotherapy and other factors on the recurrence of CSCC was not clear, with no statistically significant difference ( P>0.05). Conclusions:The course of disease (≥ 20 months), the site of the disease (the exposed part of the head), the wound healing (poor), the pathological condition of the first margin (positive) and the lymph node metastasis (with metastasis) were the risk factors for recurrence of CSCC. Early and accurate diagnosis is of great significance for the prognosis of CSCC, especially for patients with independent risk factors, early sentinel lymph node biopsy can detect metastasis and deal with it in time, so as to improve the prognosis of CSCC patients.