The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Outcomes of Treatment for Squamous Cell Carcinoma Originating as a Marjolin's Ulcer

Marjolin 궤양으로 발생한 편평 상피암의 치료결과

  • Kim, Jong-Kil (Department of Orthopaedic Surgery, Medical School, Chonbuk National University) ;
  • Yu, Chang-Eun (Department of Orthopaedic Surgery, Presbyterian Medical Center) ;
  • Kim, Jung-Ryul (Department of Orthopaedic Surgery, Medical School, Chonbuk National University)
  • 김종길 (전북대학교 의학전문대학원 정형외과학교실) ;
  • 유창은 (전주예수병원 정형외과) ;
  • 김정렬 (전북대학교 의학전문대학원 정형외과학교실)
  • Received : 2012.03.12
  • Accepted : 2012.05.30
  • Published : 2012.06.30
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Abstract

Purpose: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. Materials and Methods: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. Results: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. Conclusion: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.

목적: Marjolin 궤양으로 발생한 편평 상피암의 치료결과에 대해 원발성 편평 상피암과 비교 분석하고자 한다. 대상 및 방법: Marjolin 궤양에 의한 편평 상피암으로 치료받았던 14예를 대상으로 하였으며, 같은 기간 치료받았던 원발성 편평 상피암 20예를 대조군으로 하였다. 평균 연령은 61.2세였으며, 남자 24예였고, 여자가 10예였다. 두 군간의 발생 부위, 조직학적 분류, 병기, 치료 방법, 전이, 재발, 생존율에 대해 비교 분석하였다. 결과: 평균 추시 기간은 54.8개월(12-168개월)이었다. 국소 재발은 6예에서 발생하였고, 5예는 Marjolin 궤양 군에서, 나머지 1예는 원발성 편평 상피암 군에서 발생하였다. 최초 진단 후 국소 재발까지의 평균 기간은 9개월(2-20개월)이었다. 전이는 총 6예에서 발생하였는데 이들 중 2예(14.3%)는 Marjolin 궤양 군에서, 나머지 4예(20.0%)는 원발성 편평 상피암 군에서 발생하였다. 전이 또는 국소 재발은 총 10예에서 발생하였는데 이들 중 6예는 Marjolin 궤양 군에서, 나머지 4예는 원발성 편평 상피암 군에서 발생하였다. 5년 무병 생존률은 Marjolin 궤양 군에서는 64.3%였고, 원발성 군에서는 95%였다. 결론: Marjolin 궤양에 동반된 편평 상피암은 적극적인 치료에도 불구하고 높은 재발율 및 사망률을 보이므로, 치료 결과를 향상시키는 새로운 치료법에 대한 연구가 요구된다.

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