Squamous Cell Carcinoma Arising from Chronic Osteomyelitis in the Extremities: Treatment Approach and Oncological Outcomes—A Systematic Review of the Literature

Table 1

Clinical characteristics, treatment strategies, and related outcomes of all patients included in this study. Dx: diagnosis, SCC: squamous cell carcinoma, BKA: below-the-knee amputation, AKA: above-the-knee amputation, NA: not available, Y: yes, N: no, M: metastasis, I: inflammatory.

Author and Year

Patient no.

Gender

Age at Dx of SCC

Duration to SCC

Etiology

Site

Previous treatment approaches

Final treatment approach

Follow-up

Recurrence

Metastasis

SCC differentiation

Bone invasion

Lymph node involvement

Abdul (2017) [15]

1

Female

58

8

Open wound

Foot

Partial amputation (distal hallux) + debridement

Ray amputation

9

N

N

NA

Y

N

Akoh (2017) [16]

2

Male

44

28

Trauma

Fibula

Trans metatarsal amputation

BKA

30

N

N

Moderately

Y

Y (M)

Alami (2011) [17]

3

Male

53

25

Trauma

Tibia

NA

AKA

84

N

N

Well

Y

N

4

Male

52

40

NA

Tibia

NA

AKA

60

N

N

Well

Y

N

5

Female

49

14

Trauma

Tibia

NA

AKA

72

N

N

Well

Y

N

6

Male

71

22

Trauma

Tibia

NA

AKA

36

N

N

Well

Y

N

7

Male

60

36

NA

Femur

NA

AKA

60

N

N

Poorly

N

N

8

Male

58

26

Trauma

Femur

NA

AKA

38

N

N

Poorly

N

N

9

Male

38

9

Trauma

Humerus

NA

Treatment refused

NA

NA

NA

Well

Y

N

Altunay (2015) [18]

10

Male

53

6

NA

Foot

Amputation (5th toe)

Treatment refused

2

NA

N

Poorly

N

Y (M)

Aslan (2020) [19]

11

Female

71

60

NA

Tibia

Debridement

Additional debridement

48

Y (48)

N

NA

Y

N

Bernhard (2017) [20]

12

Male

63

20

Trauma

Tibia

NA

AKA

NA

N

N

Poorly

NA

Y (M)

Caruso (2016) [21]

13

Male

69

40

Trauma

Tibia

Wide-margin surgical debridement

BKA

2

Y (2)

N

NA

Y

N

Chagou (2020) [22]

14

Male

47

40

Hematogenous

Tibia + fibula

Sequestrectomy + fistula excision

AKA

NA

N

N

NA

Y

NA

Chiao (2014) [23]

15

Male

74

2

Diabetic foot

Foot

Sequestrectomy + debridement

Forefoot amputation

72

N

N

Well

Y

NA

Hamdani (2017) [24]

16

Male

67

51

NA

Femur

Fistula excision + curettage of bone cavity

Hip disarticulation

24

N

N

Well

Y

NA

Henning (2020) [13]

17

Female

65

NA

Open wound

Foot

Metatarsal head resection (3rd toe)

Complete amputation (3rd toe)

12

N

N

Well

Y

Y (I)

Hwang KT (2012) [25]

18

Male

79

15

Trauma

Tibia

NA

En bloc resection

18

N

N

NA

Y

N

Karasov Yesilada (2013) [26]

49

Male

55

43

NA

NA

NA

Tumor excision

NA

NA

NA

Poorly

NA

NA

Kersh (2010) [27]

19

Male

62

NA

NA

Foot

NA

Amputation (5th digit) + resection (Mohs Qx)

16

N

N

Moderately

N

N

Khaladj (2015) [28]

20

Male

89

0.25

NA

Foot

Partial amputation (3rd toe)

Amputation (3rd toe)

NA

NA

NA

Poorly

Y

NA

Kurihara (2019) [30]

21

Male

69

54

Trauma

Femur

Multiple surgeries

Hip disarticulation

8

N

Y (6)

Well

Y

NA

Lack (2010) [31]

22

Female

66

11

Open wound

Pelvic bone + femur

Debridement + proximal femur resection + ischium partial excision

Hemipelvectomy

2

N

Y (0)

Well

Y

Y (M)

Li (2015) [32]

23

Male

51

13

Trauma

Ankle

NA

Treatment refused

NA

NA

NA

Well

Y

N

24

Male

61

40

Trauma

Femur

NA

Hip disarticulation

60

N

N

Poorly

NA

N

25

Female

52

33

NA

Tibia

NA

BKA

60

N

N

Well

Y

N

26

Female

66

20

NA

Tibia

NA

BKA

60

N

N

Poorly

NA

N

27

Male

45

30

Trauma

Tibia

NA

BKA

60

N

N

Poorly

NA

N

28

Male

53

30

Trauma

Tibia

NA

BKA

60

N

N

Poorly

NA

N

29

Male

52

8

Trauma

Tibia

NA

BKA

60

N

N

Poorly

NA

N

30

Male

58

50

Trauma

Tibia

NA

BKA

60

N

N

Poorly

NA

N

Monaco (2015) [33]

31

Male

60

10

Open wound

Foot

Debridement + multiple reconstructive surgeries

BKA

10

N

N

Poorly

N

NA

Moura (2017) [34]

32

Male

72

65

Trauma

Femur + tibia + fibula

NA

AKA

96

N

N

NA

NA

Y (I)

33

Male

63

57

Hematogenous

Tibia

NA

AKA

NA

N

N

NA

NA

N

34

Male

69

62

Hematogenous

Tibia

NA

AKA

24

N

N

NA

NA

N

35

Male

49

43

Trauma

Tibia

NA

AKA

84

N

N

NA

NA

N

36

Male

42

32

Trauma

Tibia

NA

AKA

12

N

N

NA

NA

N

37

Male

75

36

Trauma

Tibia

NA

AKA

6

N

Y (5)

NA

NA

N

Moyer (2016) [35]

38

Male

70

21

Open wound

Tibia

NA

BKA

12

NA

NA

Well

NA

NA

Peng (2020) [36]

39

Male

59

9

Trauma

Tibia + fibula

NA

AKA

NA

NA

NA

Well

NA

NA

40

Male

58

40

Trauma

Tibia + fibula

NA

AKA

NA

NA

NA

Well

NA

NA

41

Male

66

50

NA

Tibia

NA

BKA

NA

NA

NA

Well

NA

NA

Stanger (2015) [37]

42

Male

86

35

Trauma

Tibia

NA

Resection

6

N

NA

NA

NA

NA

Steinrücken (2012) [38]

43

Female

62

40

NA

Humerus

No previous surgery

Transhumeral amputation

36

Y (36)

N

Well

Y

NA

44

Female

54

12

Trauma

Tibia + fibula

Previous surgeries (including surgical excision)

Amputation (left foot)

12

N

N

Well

Y

NA

45

Male

59

21

Trauma

Tibia

Previous surgeries (14, including sequestrectomy and debridement)

AKA

6

N

N

Well

Y

NA

46

Male

52

19

Trauma

Tibia + fibula

Previous surgeries (4, including 2 sequestrectomies)

AKA

36

N

N

Well

Y

NA

47

Male

56

30

Trauma

Tibia

Previous surgeries (6)

Treatment refused

NA

NA

NA

Well

Y

NA

48

Male

77

39

Trauma

Tibia

Previous surgeries (3, including sequestrectomy, vancomycin-impregnated spacer)

BKA

NA

N

N

Well

Y

NA

Data displayed in columns Age at diagnosis, Duration to SCC refers to years, and data displayed in all remaining columns refer to months. Data displayed in brackets in the Recurrence and Metastasis columns refer to months elapsed until the event happened. Data displayed in brackets in the Lymph node involvement column refers to the inflammatory or metastatic causes of the lymph node involvement.