Current Medical Science

, Volume 38, Issue 6, pp 1038–1044 | Cite as

Clinicopathologic Characteristics and Prognosis Analysis of Marjolin’s Ulcer in 40 Cases

  • Bi-wei Guo
  • Teng Pan
  • Hong-bo Chen
  • Li Zhu
  • Meng Tian
  • Jie-cong WangEmail author
  • Xiao-dan LiEmail author


Marjolin’s ulcer (MU) is a rare but aggressive epidermoid carcinoma observed in scars or wounds. This article provides comprehensive characteristics and prognostic details of MU. Clinical data of 40 patients with MU between January 2010 and December 2017 were analyzed retrospectively. Squamous cell carcinoma was the most common pathological type (35/40, 87.5%). Extended resection was performed to treat all cases with skin grafting or flap grafting. Follow-up duration ranged from 6 to 96 months (median, 52 months) and recurrence was noted in 9 cases. The 1-, 3- and 5-year recurrence-free survival (RFS) rates were 87.2%, 87.2%, 83.2% respectively and the recurrence rate was 22.5%. Univariate analysis revealed that cause of scars (P=0.044), lesion appearance (P=0.036), ultraviolet radiation exposure (P=0.000), depth (P=0.001) and histological grade (P=0.027) had a statistically significant correlation with prognosis of MU. Multivariate analysis revealed that depth (P=0.034, RR=2.681, 95%CI: 1.077–6.674) and histological grade (P=0.008, RR=2.820, 95%CI: 1.315–6.050) were independent prognostic factors for RFS. In conclusion, superficial infiltration and high-grade differentiation predict more favorable prognosis. Careful follow-up of high-risk groups is strongly recommended to prevent recurrence and improve prognosis.

Key words

Marjolin’s ulcer clinicopathological pattern prognosis 


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  1. 1.
    Shahla A. An overview of heel Marjolin’s ulcers in the Orthopedic Department of Urmia University of Medical Sciences. Arch Iran Med, 2009,12(4):405–408Google Scholar
  2. 2.
    Shen R, Zhang J, Zhang F, et al. Clinical characteristics and therapeutic analysis of 51 patients with Marjolin's ulcers. Exp Ther Med, 2015,10(4):364–1374Google Scholar
  3. 3.
    Copcu E. Marjolin’s ulcer: a preventable complication of burns? Plast Reconstr Surg, 2009,124(1):156e-164eCrossRefGoogle Scholar
  4. 4.
    Huang CY, Feng CH, Hsiao YC, et al. Burn scar carcinoma. J Dermatolog Treat, 2010,21(6):350–356CrossRefGoogle Scholar
  5. 5.
    Kowal-Vern A, Criswell BK. Burn scar neoplasms: a literature review and statistical analysis. Burns, 2005,31(4): 403–413CrossRefGoogle Scholar
  6. 6.
    Saaiq M, Ashraf B. Marjolin’s ulcers in the post-burned lesions and scars. World J Clin Cases, 2014,2(10):507–514CrossRefGoogle Scholar
  7. 7.
    Qiu XJ, Zhang J, Wang J, et al. Application of paclitaxel as adjuvant treatment for benign cicatricial airway stenosis. J Huazhong Univ Sci Technolog Med Sci, 2016,36(6):817–822CrossRefGoogle Scholar
  8. 8.
    Choi JY, Bae YC, Nam SB, et al. Impact of disturbed wound healing after surgery on the prognosis of Marjolin’s ulcer. Arch Plast Surg, 2013,40(3):198–202CrossRefGoogle Scholar
  9. 9.
    Chalya PL, Mabula JB, Rambau P, et al. Marjolin’s ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases. World J Surg Oncol, 2012,10:38CrossRefGoogle Scholar
  10. 10.
    Eroglu A, Camlibel S. Risk factors for locoregional recurrence of scar carcinoma. Br J Surg, 1997,84(12):1744–1746CrossRefGoogle Scholar
  11. 11.
    Wallingford SC, CM Olsen, E Plasmeijer, et al. Skin cancer arising in scars: a systematic review. Dermatol Surg, 2011,37(9):1239–1244CrossRefGoogle Scholar
  12. 12.
    Sadegh Fazeli M, Lebaschi AH, Hajirostam M, et al. Marjolin’s ulcer: clinical and pathologic features of 83 cases and review of literature. Med J Islam Repub Iran, 2013,27(4): 215–224Google Scholar
  13. 13.
    Challa VR, Deshmane V, Ashwatha Reddy MB. A Retrospective Study of Marjolin’s Ulcer Over an Eleven Year Period. J Cutan Aesthet Surg, 2014,7(3):155–159CrossRefGoogle Scholar
  14. 14.
    Ye Z, Xie W, Long Z, et al. Analysis of diagnosis and management of 21 patients with Marjolin’s ulcers. Zhonghua Shao Shang Za Zhi (Chinese), 2014,30(6):491–494Google Scholar
  15. 15.
    Liu Z, Zhou Y, Zhang P, et al. Analysis of clinical characteristics of 187 patients with Marjolin’s ulcers. Zhonghua Shao Shang Za Zhi (Chinese), 2016,32(5): 293–298Google Scholar
  16. 16.
    Metwally IH, Roshdy A, Saleh SS, et al. Epidemiology and predictors of recurrence of Marjolin’s ulcer: experience from Mansoura Universityxs. Ann R Coll Surg Engl, 2016,99(3):245–249CrossRefGoogle Scholar

Copyright information

© Huazhong University of Science and Technology 2018

Authors and Affiliations

  1. 1.Department of Plastic Surgery, Department of Dermatology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Department of AnesthesiologyJining No.1 People’s HospitalJiningChina
  3. 3.The Ninth Department of Plastic Surgery, Plastic Surgery HospitalChinese Academy of Medical SciencesBeijingChina

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