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Michael J. Edwards, MD; Rose M. Hirsch, MD; J. Ralph Broadwater, MD; David T. Netscher, MD; Frederick C. Ames, MD

Arch Surg. 1989;124(1):115-117.

Abstract
• Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5,10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation.

(Arch Surg 1989;124:115-117)

Author Affiliations
From the Division of Surgery, Department of General Surgery, University of Texas M. D. Anderson Cancer Center, Houston.

Footnotes
Accepted for publication Sept 2, 1988.

Read before the Annual Meeting of the Society of Surgical Oncology, New Orleans, May 24, 1988.

Reprint requests to University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 106, Houston, TX 77030 (Dr Edwards).

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