อัตราการตรวจพบเซลล์มะเร็งผิวหนังชนิดเบซัลเซลล์ที่หลงเหลืออยู่ในชิ้นเนื้อจากการผ่าตัดซ้ำ ในผู้ป่วยของโรงพยาบาลสมุทรสาคร ที่พบเซลล์มะเร็งบางส่วนที่ขอบของชิ้นเนื้อจากการผ่าตัดครั้งแรก

ผู้แต่ง

  • Kittpong Chompoopongkasem, M.D. กลุ่มงานศัลยกรรม โรงพยาบาลสมุทรสาคร

คำสำคัญ:

โรคมะเร็งผิวหนังชนิดเบซัลเซลล์, การตรวจพบเซลล์มะเร็งที่หลงเหลือ, การตรวจพบเซลล์มะเร็งบริเวณขอบของชิ้นเนื้อ, การผ่าตัดก้อนออกได้ไม่ทั้งหมด, การผ่าตัดซ้ำ

บทคัดย่อ

          Objectives: This research aims to study residual tumor rate of re-excision in the patients with positive margin basal cell carcinoma and recurrence rate within 3 years at Samutsakhon Hospital.

          Material and Methods: This is a descriptive cohort study in the patients with basal cell carcinoma at Samutsakhon Hospital between July 2007 to July 2012. The patients that underwent surgery during July 2007 to July 2009 were enrolled. The patients' demographic data were collected. In cases of incomplete excision, the patients were scheduled to re-excise within 1 week. The residual tumor rate of re-excision was analyzed. All of the patients were followed up for 3 years after surgery. The 3-year recurrence rate was analyzed.

          Results: Thirty seven patients were enrolled. Mean age of the patients was 73.0 -± 9.7 years. Nineteen patients were male (51%) and 18 patients were female (49%). Most common sites of tumor were the nasal area, 15 patients (40.5%) and the cheek area, 15 patients (40.5%). Mean tumor size was 13.59 ± 7.44 millimeters. Mean lateral margin was 3.19 ± 2.35 millimeters. Mean deep margin was 3.43 ± 1.98 millimeters. Incomplete excision occurred in 6 patients (positive margin rate was 16.2%) and all of them appeared in the nasal and the cheek areas (3 patients and 3 patients, respectively). After re-excision within 1 week, no residual tumor was detected in all patients with positive-margin basal cell carcinoma (residual tumor rate 7- 0) and no 3-year recurrence rate.

          Conclusion: Wide excision of basal cell carcinoma had a chance of positive margin rate, especially in facial area. Conservative treatment by observation at least 3 years might be an alternative choice instead of re-excision, however modes of treatment depended on the decisions of the surgeons, the patients and their families.

Author Biography

Kittpong Chompoopongkasem, M.D., กลุ่มงานศัลยกรรม โรงพยาบาลสมุทรสาคร

ว.ว. ศัลยศาสตร์ทั่วไป

ว.ว. ศัลยศาสตร์ตกแต่ง

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เผยแพร่แล้ว

2018-09-06