Retrospective study of Mohs micrographic surgery for patients with skin squamous cell carcinoma of the head attended in the dermatologic surgical facility of the Dermatological Division of the HC from FMUSP/SP, to establish predictive factors for the number of surgical / Estudo retrospectivo da cirurgia micrográfica de Mohs nos portadores de carcinoma espinocelular cutâneo da cabeça para a determinação de fatores preditivos do número de fases cirúrgicas, acompanhados no ambulatório de cirurgia dermatológica da Divisão de Dermatologia do HC da FMUSP/SP

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Mohs micrographic surgery (MMS) is proceeded in successive stages of cancer removal. Each stage lasts from 1 to 2 hours, depending on the tumor size. So it is very important to predict the number of phases of the surgery so that one can plan better the time of the surgical room use, the time of the surgeon and his team, the use of anaesthetics, the surgical costs, to give the patient better orientations about his surgery and to ensure complete tumor erradication. With the intention to find predictive factors of the number of stages of MMS in the treatment of squamous cell carcinoma, we reviewed the record of 44 patients on a total of 51 surgeries proceeded in the dermatologic surgical clinic of the Dermatological Division of HC-FMUSP/SP from 1994 to 2003. For the number of stages in the MMS we established 3 groups: 1 stage, 2 stages and 3 or more stages. These groups were compared with regard to this variables: continuance of the lesion until the surgery, morphology and size of the lesion, lesion limits, primary or recurrent cancer, histological grade (Broders) and anatomic localization. In the univariated analysis one single factor was significant: the distribution of the recurrent cancers related to the number of stages of the surgery that was different from the distribution of the primary ones (p=0.081, Fishers exact test), been higher the number of stages for the recurrent cancers. In the multivariated analysis, there were no statistically significant factors associated with higher number of stages of the surgery. In the analysis of the odss ratio, we noted a higher chance of a higher number of stages for the variables: inaccurate clinical limits, ulcerated lesions, recurrent cancer, higher aggressive histology and tumor bigger than 1 cm.

ASSUNTO(S)

carcinoma de células escamosas/cirurgia head and neck neoplasms/surgery mohs surgery/tendency neoplasias de cabeça e pescoço/cirurgia registros médicos/estatística &dados numéricos review article squamous cell carcinoma/surgery carcinoma de células escamosas/epidemiologia literatura de revisão medical files/statistics and numeric data squamous cell carcinoma/classification cirurgia de mohs/tendências estudos retrospectivos retrospective studies squamous cell carcinoma/epidemiology mohs surgery/statistics and numeric data carcinoma de células escamosas/classificação cirurgia de mohs/estatística &dados numéricos

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