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Análisis retrospectivo del carcinoma cutáneo tipo basecelular y escamocelular en Bogotá-Colombia: Epidemiología, prevención y tratamiento
A retrospective analysis of basall cell and squamous cell skin carcer in Bogota, Colombia: its epidemiology, prevention and treatment
Palabras clave:
carcinoma basocelular, carcinoma de células escamosas, morbilidad, neoplasias por tipo histológico. (es)carcinoma, basal cell, squamous cell, morbidity, neoplasms by histologic type. (en)
Antecedentes. El carcinoma cutáneo no melanoma del tipo basocelular (CBC) y escamocelular (CEC), tiene tasas de incidencia cercanas al 13 por ciento y es el más prevalente en la población blanca. Trae elevada morbilidad para el paciente y altos costos para el sistema de salud, y aunque es la neoplasia maligna mas frecuentemente diagnosticada, en Colombia sólo se tienen estadísticas en instituciones oncológicas, haciendo énfasis principalmente en melanomas. Entre los principales factores de riesgo se encuentra la exposición a los RUVB, tipo de piel, la radiación, el virus del papiloma humano (HPV) y su tratamiento incluye medicación tópica, crioterapia, electrofulguración y cirugía.
Objetivo. Analizar algunas características epidemiológicas del cáncer cutáneo (CBC - CEC) en nuestro medio, estableciendo similitudes y diferencias respecto a la literatura actual.
Material y métodos. En la clínica San Pedro Claver se revisaron 202 historias clínicas de pacientes con diagnóstico confirmado de CBC O CEC de 2004 a 2006 en un estudio retrospectivo de serie de casos y se analizaron las variables más comunes como el tipo de lesión, su ubicación, tamaño, patrón histológico y tratamiento.
Resultados. Ingresaron en el estudio 112 pacientes, de los cuales cerca del 60 por ciento eran hombres, con una edad media de 69.5 años. El 90 por ciento de las lesiones se localizaban en cara (mejillas, párpados, nariz). Del 70 por ciento de las lesiones que correspondían a CBC el tipo histológico más frecuente fue sólido nodular y del 22 por ciento de lesiones que correspondían a CEC, el moderadamente diferenciado de célula grande fue el más común. Las lesiones tuvieron un tamaño promedio de 2 cm y los procedimientos quirúrgicos más usados fueron resección más injerto (44.1%), seguido de resección más colgajo local (23.5%). El 5 por ciento de los pacientes tenían lesiones previas y uno de cada cuatro tuvo algún tipo de recaída.
Conclusiones. En Colombia las estadísticas del carcinoma cutáneo (CBC y CEC) tienen un patrón de comportamiento similar a los reportados en la literatura y el pronóstico depende de un adecuado diagnóstico y tratamiento, así como de una intervención oportuna en los factores de riesgo.
Background. Basal cell (BCC) and squamous cell (SCC) non-melanomous skin cancer has close to 13 percent incidence rate and is the most prevalent cancer occurring amongst the white population. It involves high morbidity for the patient and high costs for the health system and, although it is the most frequently diagnosed malignancy, only oncological institutions have statistics regarding it in Colombia, mainly emphasizing melanomas. The main risk factors are exposure to UV-B radiation, skin type, radiation, human papillomavirus (HPV); its treatment includes topical medication, cryotherapy, electrofulguration and surgery.
Objective. Analysing some epidemiological characteristics of cutaneous cancer (BCC-SCC) in our environment, establishing similarities and differences regarding the current literature. Materials and methods. The medical records of 202 patients having a confirmed diagnosis of BCC or SCC from 2004 to 2006 attending the San Pedro Claver hospital were reviewed in a retrospective study of a series of cases. The most common variables were analysed, such as the type of injury, its location, size, histological pattern and treatment.
Results. 112 patients were enrolled in the study; nearly 60 percent were male and average age was 69.5. 90% of the injuries were located on the face (cheeks, eyelids, nose). The most frequent pathology for the 70% of injuries corresponding to BCC was solid nodular and 22% of injuries related to SCC, moderately differentiated large cell being most commonly occurring one. The injuries had 2 cm average size; the most used surgical procedures were graft plus resection (44.1%), followed by local flap plus resection (23.5%). 5% percent of the patients had had prior injuries and one in four had had some type of relapse.
Conclusions. The statistics for skin cancer (BCC and SCC) in Colombia have a similar behavior pattern to that reported in the literature; prognosis depends on appropriate diagnosis and treatment, as well as opportune intervention regarding risk factors.
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