Refining the Classification of Field Cancerization

作者：Bo Kitrell, Ashley B. Crew, Ashley Wysong, Adam Sutton · 发表于：Dermatologic Surgery · 年份：2023 · DOI：10.1097/dss.0000000000003700 · 被引用次数：7 · 研究领域：Nonmelanoma Skin Cancer Studies、Cutaneous Melanoma Detection and Management、Cancer and Skin Lesions

BACKGROUND: Field cancerization is a commonly encountered but poorly defined entity in dermatology. Lack of a consensus definition makes characterizing and studying this condition difficult. OBJECTIVE: Propose a framework for defining and managing field cancerization patients. METHODS: Clinical experience and available data in the literature was used to develop a proposed field cancerization disease classification system and chemoprevention algorithm. RESULTS: The author group developed a field cancerization classification and treatment algorithm that stratifies patients into 5 different classes based on the extent of their field cancerization. They have started to recruit and study the highest risk cohort (Category 4 or 5) and have recruited 57 patients with 5 or more lifetime keratinocyte carcinomas for a prospective study evaluating chemoprevention strategies and disease burden. In these cohorts, the average number of skin cancers was greater than 12; however, less than 39% of these patients had used any chemoprevention in the prior 6 months. CONCLUSION: A meaningful and clinically relevant disease stratification framework with chemoprevention guidance has the potential to highly impact the specialty and patients.