Carcinoma de células escamosas de piel. Serie de casos

Abstract

Introduction: Squamous skin cancer (SSC) is the second most frequent skin cáncer, nevertheless reports about this issue are not published in Chile. Objetive: To investigate social, demographics, and clinic characteristics of SSC in semidesertic Coquimbo Region, Chile. Material and Methods: serie of patients diagnosed and treated in Coquimbo hospital between January 2006 and December 2015. Inclussion criteria: 1.-histopathological confirmation of SSC. Exclusion criteria: 1.-follow up lesser than 12 months; 2.-operated in another hospital; 3.-submitted to another treatment prior to surgery; 4.-skin metastasis of mucous squamous carcinoma; 5.-patients with distant metástasis. Independent variables: age, gender, tumor site, tumor size, clinical lymph nodes, shore or valley residency. Dependent variable: recurrency frecuence, factors of recurrency, letality. Statistical analysis: descriptive and analytical by SSPS program.Results: 2.202 skin cancer cases were registered, 1.487 basal cells carcinoma (67.5%), 181 melanoma (8.2%) and 534 squamous cells carcinoma (24.2%). 236 patients with complete data are included in this report. There were 153 men (64.8%), and 83 women (35.2%). Mean age was 75.5 years old ± 11.7 (range 46-94). Primary site was: head 158 patients (66.9%), other sun exposed areas 47 patients (20%), and non exposed areas 31 patients. Cheek and front were the most frequents head site with 40 cases (25%) and 29 cases (12.3%), respectively. In 119 cases (50.4%) SCC was ulcerated, and 117 cases was not; primary tumor diameter was 22 millimeters (range 3-100). Clinical lymph nodes were primarily positives in 10 patients, (4.2%). In 12 cases with negative lymph nodes, sentinel limph node was resected. 2 were positives. Histological borders were tumor free in 201 patients (85.2%) and, 35 cases (14.8%) had positive histological borders. Local recurrence incidence was 8.5% (20 cases). Limph nodes recurrence was 2.1% (5 cases). Cancer recurrence was associated with histological positive borders P = 0.001, IC 95% 3.12-12.19, and ulcerated tumor p = 0.01, OR 4.63; IC 1.59-13.50. Letality was 2.56%. Mean follow up was 36 months (range 12-228 months). Conclusions: SSC has a good prognosis when primary tumor is resected early, with free histological borders resection.

Fatores relacionados ao câncer de pele não melanoma na população masculina

“…O epidermóide apresenta-se com ferida de espessura significativa, alteração na pigmentação da pele, descamação e enrugamento associado a perca da elasticidade local [5]. O CPNM acomete em maior número pessoas idosas, com média de 75 anos de idade [12], especialmente as que possuem histórico familiar positivo para carcinoma basocelular, aumentando as chances de 30% a 60% nesse grupo [13], podendo ser justificado pelo diagnóstico tardio e o efeito cumulativo da exposição prolongada ao decorrer da vida jovem e adulta [14].…”

“…Um estudo observacional retrospectivo, elaborado no estado brasileiro do Rio Grande do Norte, revelou que de 758 casos de CPNM, 440 correspondiam a homens (58%), com média de idade de 68 anos. Em uma pesquisa realizada no Chile, dos 236 pacientes diagnosticados com a doença 153 eram homens (64,85%) e 83 mulheres (35,2%), ambos resultados ratificam uma prevalência de casos no público masculino [14,15].…”