title: Limb amputation for squamous cell carcinoma of the skin: factors involved in this poor evolution.
abstract: OBJECTIVE
  To analyze retrospectively a series of cases culminating in amputation for advanced squamous cell carcinoma.
  
  
  METHODS
  We studied eight patients with histologically confirmed squamous cell carcinoma of the skin that had limbs amputated by tumor invasion at our institution between 2005 and 2008. We evaluated the histological factors and the institutional and psychosocial factors that contributed to this unfavorable outcome.
  
  
  RESULTS
  The mean age at diagnosis was 63 years, 37.5% of patients (three patients) had a history of abusive and continuous exposure to sunlight and six (75%) patients had other risk factors for SCC of the skin. Seven patients were diagnosed when the tumor was already larger than 2cm, and it required a large period of time (6.7 years on average) between the onset of the initial lesion and the correct histopathological diagnosis of locally advanced tumor.
  
  
  CONCLUSIONS
  The unfavorable outcome (amputation) in patients with squamous cell carcinoma may be associated with aggressiveness of cancer and related comorbidities, and may also be influenced by factors such as access to public health, quality of care and patient's relationship with the disease.
authors: Centro de Oncologia, Hospital Alberto Cavalcanti, Fundação Hospitalar do Estado de Minas Gerais, MG, Brazil. albertojaw@gmail.com
authors: Alberto Julius Alves
authors: AJ
authors: Wainstein
authors: Thiago Augusto
authors: TA
authors: de Oliveira
authors: Daniel Claus Fruk
authors: DC
authors: Guelfi
authors: Barbara Roberta
authors: BR
authors: Gontijo
authors: Eduardo Vitor
authors: EV
authors: de Castro
authors: Rafael Almeida
authors: RA
authors: de Carvalho
authors: Nathalia Mansur
authors: NM
authors: Paz
authors: Lycia Tobias
authors: LT
authors: Lacerda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D016896:Treatment Outcome