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PubMed2005

Burn scar neoplasms: a literature review and statistical analysis.

BACKGROUND: Although squamous cell carcinoma (SCC) is the most common burn scar neoplasm, other neoplasms have also been reported. OBJECTIVE: To compile the burn scar neoplasm cases in the literature and to analyze their frequency and demographic characteristics. MATERIALS AND METHODS: Cases were obtained through literature searches. RESULTS: There were 412 cases gleaned from 146 articles between 1923 and 2004. Seventy-one percent (293) of the tumors were squamous cell carcinoma, 12% (48) were basal cell carcinoma (BCC), 6% (23) were melanoma, 5% (21) were sarcoma, 4% (16) were other neoplasms, 1% (6) were squamo-basal cell carcinoma, and 1% (5) squamous cell-melanoma. The mean age at tumor diagnosis was 50 years, the mean age at the time of burn injury was 20 years, the mean latency interval was 31 years. Only 5% of the reported cases were excised and grafted at the time of injury (p<0.001). BCC occurred at a significantly later age compared to SCC and sarcoma groups (p<0.02) and had a shorter latency period compared to SCC and sarcoma groups (p<0.004) and melanoma (p<0.008). Local recurrence was present in 16% of the cases, while regional lymph node involvement was seen in 22% of the cases and distant metastases was present in 14% of the patients. The mortality rate was 21%. CONCLUSIONS: Although the main burn scar neoplasm was SCC, other neoplasms contributed to the morbidity and mortality of burn patients. Excision and grafting of deep burns, and close follow-up of non-healing ulcerated burn scars is essential for the prevention and early detection of burn scar neoplasms.

Adult↗
PubMed1997

A semi-parametric estimate of extra-Poisson variation for vital rates.

We introduce a method for estimating overdispersion in Poisson models for vital rates. We assume smoothness conditions on the counts to obtain pointwise variance estimates that we combine to obtain an estimate of the overdispersion parameter. We create confidence intervals about the observed rates using this estimate and an approximation based on the gamma distribution. The advantage of this method is that the estimates of the superpopulation rates do not depend on the smoothness assumption, yet when this assumption is met we obtain approximately unbiased estimates of the overdispersion parameter. Thus, we may calculate confidence intervals for vital rates under an overdispersed Poisson model without making parametric assumptions on the mean rates.

Adult↗