Fuat YÜKSEL, Hüseyin KARAGÖZ, Ersin ÜLKÜR, Bahattin ÇELİKÖZ, Cengiz AÇIKEL

Melanoma dışı deri kanserlerinin nüks oranları: 11 yıllık retrospektif analiz

Bazal hücreli ve skuamoz hücreli deri kanserlerinde, tümör hücreleri genelde makroskobik olarak gördüğümüz sınırdan daha ileriye yayılmış olduğu için, cerrahi eksizyon yapılırken, lezyonla birlikte bir miktar sağlam deri de eksize edilir. Kliniğimizde bazal hücreli kanserler 3-5 mm, skuamoz hücreli kanserler ise 4-6 mm sağlam deri dokusu ile birlikte eksize edilmektedir. Ocak 1994-Ocak 2005 tarihleri arasında servisimize başvuran; melanoma dışı deri kanseri tanısı konularak ayaktan lokal anastezi altında tedavi edilen ve takibe alınan 516 hasta retrospektif olarak değerlendirildi ve rekürrens oranları ortaya kondu. Melanoma dışı deri kanseri tanısı konulan 516 olgunun 378'i (%73,2) bazal hücreli kanser, 138'i (%26,8) skuamoz hücreli kanser idi. 33 bazal hücreli kanser olgusunda (%8,7) ve 10 skuamoz hücreli kanser olgusunda (%7,2) rekürrens izlendi. Rekürrens gözlenen bazal hücreli kanserlerin tamamı (% 100), skuamoz hücreli kanserlerin ise 8 tanesi (%80) baş boyun bölgesinde lokalize idi. Elde edilen rekürrens oranları literatürde belirtilenlere göre yüksektir. Bu çalışmanın sonuçları, eksizyon sınırlarının kozmetik ve fonksiyonel kaygılar gibi çeşitli nedenlerle dar tutulmasının kanser rekürrensini artırdığını düşündürmektedir.

The recurrence frequency of nonmelanotic skin cancers: A retrospective analysis over 11 years

Background and Design.- Surgical excision of basal cell and squamous cell carcinoma includes a margin of healthy skin, because the microscopic margin is often considered to extend beyond the macroscopic margin. According to our general clinical principals, we excise the majority of basal cell carcinomas with a 3-5 mm, and squamous cell carcinomas with 4-6 mm margin of skin that appears clinically healthy with local anesthesia. Results.- This retrospective study of 516 patients treated surgically for primary nonmelanotic skin cancer was conducted from January 1994 to January 2005 and frequency of recurrence was defined. The sum of the patients with basal cell carcinoma was 378 (73.2%), and squomous cell carcinoma was 138 (26.8%). The number of the recurrence was 33 with basal cell carcinoma and 10 with squamous cell carcinoma. All of the recurrent basal cell carcinomas and the 8 (80%) of recurrent squamous cell carcinomas were at the head and neck region. The frequency of recurrence is higher than the literature. Conclusion.- Results of this study suggest that reduced excision margins anyway increased recurrence rate of tumor.

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