11년간 경험한 피부의 악성종양에 대한 임상적 고찰

A Retrospective Clinical Study of Skin Cancer: A Single Institution's Experience on 370 Cases

  • 이태성 (성균관대학교 의과대학 삼성서울병원 성형외과학교실) ;
  • 변재경 (성균관대학교 의과대학 삼성서울병원 성형외과학교실) ;
  • 문구현 (성균관대학교 의과대학 삼성서울병원 성형외과학교실) ;
  • 방사익 (성균관대학교 의과대학 삼성서울병원 성형외과학교실) ;
  • 오갑성 (성균관대학교 의과대학 삼성서울병원 성형외과학교실) ;
  • 임소영 (성균관대학교 의과대학 삼성서울병원 성형외과학교실)
  • Lee, Tae Sung (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Pyon, Jai Kyong (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Mun, Goo Hyun (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bang, Sa Ik (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Oh, Kap Sung (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, So Young (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2008.02.23
  • 발행 : 2008.05.10

초록

Purpose: The incidence of skin cancer is increasing throughout the world including Asian countries such as Korea. Still there are only limited reports of the clinical features of skin cancer in Korea, especially in the fields of plastic surgery. This study is to demonstrate the recent clinical trends of skin cancer and the treatment of skin cancer in Korea by analyzing a single institution's experience. Methods: During a 11-year period, 370 patients visited our department for the excision of skin cancer. Data of the patients such as histopathologic diagnosis, primary site of the tumor, age and sex of the patient, operative methods were reviewed retrospectively. Results: We had 370 patients, 215 men and 155 women. The ages ranged from 10 to 95 years with a mean of 58.8 years. A total of 143 patients were diagnosed as basal cell carcinoma, while 100 were malignant melanoma, 80 were squamous cell carcinoma, 17 were dermatofibrosarcoma protuberans, and 30 were other miscellaneous skin cancers. Local flaps were the most frequently used reconstructive method after wide excision of the cancer, which was followed by primary closure, split-thickness skin graft, free flap and full-thickness skin graft. Conclusion: There was a gradual increase in the incidence of skin cancer after the year 2000. Basal cell carcinoma had the highest incidence which frequently involved the sun-exposed regions in the old ages. Malignant melanoma showed a relatively high incidence compared with other previous studies in Korea. The extremities were the most frequent location for malignant melanoma. Clinical features of other various skin cancers were also reported in this study. The reconstructive method highly depends on the primary site of the cancer, while local flaps were the mostly used operative technique.

키워드

참고문헌

  1. Bivens MM, Bhosle M, Balkrishnan R, Camacho FT, Feldman SR, Fleischer AB Jr: Nonmelanoma skin cancer: is the incidence really increasing among patients younger than 40? A reexamination using 25 years of U.S. outpatient data. Dermatol Surg 32: 1473, 2006 https://doi.org/10.1111/j.1524-4725.2006.32358.x
  2. Brewster DH, Bhatti LA, Inglis JH, Nairn ER, Doherty VR: Recent trends in incidence of nonmelanoma skin cancers in the East of Scotland, 1992-2003. Br J Dermatol 156: 1295, 2007 https://doi.org/10.1111/j.1365-2133.2007.07892.x
  3. Demers AA, Nugent Z, Mihalcioiu C, Wiseman MC, Kliewer EV: Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population. J Am Acad Dermatol 53: 320, 2005 https://doi.org/10.1016/j.jaad.2005.03.043
  4. Rigel DS, Friedman RJ, Kopf AW: The incidence of malignant melanoma in the United States: issues as we approach the 21st century. J Am Acad Dermatol 34: 839, 1996 https://doi.org/10.1016/S0190-9622(96)90041-9
  5. Kraemer KH, Lee MM, Andrews AD, Lambert WC: The role of sunlight and DNA repair in melanoma and nonmelanoma skin cancer. The xeroderma pigmentosum paradigm. Arch Dermatol 130: 1018, 1994 https://doi.org/10.1001/archderm.130.8.1018
  6. Netscher DT, Spira M: Basal cell carcinoma: an overview of tumor biology and treatment. Plast Reconstr Surg 113: 74E, 2004 https://doi.org/10.1097/01.PRS.0000113025.69154.D1
  7. Rudolph R, Zelac DE: Squamous cell carcinoma of the skin. Plast Reconstr Surg 114: 82e, 2004
  8. Goldberg MS, Doucette JT, Lim HW, Spencer J, Carucci JA, Rigel DS: Risk factors for presumptive melanoma in skin cancer screening: American Academy of Dermatology National Melanoma/Skin Cancer Screening Program experience 2001-2005. J Am Acad Dermatol 57: 60, 2007 https://doi.org/10.1016/j.jaad.2007.02.010
  9. Leibovitch I, Huilgol SC, Selva D, Richards S, Paver R: Basal cell carcinoma treated with Mohs surgery in Australia I. Experience over 10 years. J Am Acad Dermatol 53: 445, 2005 https://doi.org/10.1016/j.jaad.2005.04.083
  10. Hughes JR, Higgins EM, Smith J, Du Vivier AW: Increase in non-melanoma skin cancer--the King's College Hospital experience(1970-92). Clin Exp Dermatol 20: 304, 1995 https://doi.org/10.1111/j.1365-2230.1995.tb01330.x
  11. Shin JH, Cho SY, Whang KK, Hahm JH: An epidemiologic analysis of cutaneous malignant tumors over 15 years(1984-1998). Korean J Dermatol 37: 1743, 1999
  12. Jin HR, Lee JY, Lee DW, Shin SO, Choi YS, Yoo SJ, Yoon TY: Primary facial skin cancer: clinical characteristics and surgical outcome in Chungbuk Province, Korea. J Korean Med Sci 20: 279, 2005 https://doi.org/10.3346/jkms.2005.20.2.279
  13. Choi SJ, Bae YC, Moon JS, Nam SB, Oh CG, Kwak HS, Kim CW: An analysis of clinical and histopathological pattern of malignant melanoma. J Korean Soc Plast Reconstr Surg 34: 557, 2007
  14. McArthur G: Dermatofibrosarcoma protuberans: recent clinical progress. Ann Surg Oncol 14: 2876, 2007 https://doi.org/10.1245/s10434-007-9480-y
  15. Reddy C, Hayward P, Thompson P, Kan A: Dermatofibrosarcoma protuberans in children. J Plast Reconstr Aesthet Surg 18: Epub ahead of print, 2007