背景 指甲单位鳞状细胞癌（nSCC）是一种恶性甲下肿瘤。尽管其转移和死亡的风险较低，但肿瘤的局部复发率很高。对于不涉及骨骼的 nSCC，没有足够的数据来确定功能性手术是否不如截肢术有效。目的 我们旨在调查有关无骨侵犯的 nSCC 功能性手术和截肢结果的现有数据。材料和方法我们在 PubMed、Embase、Cochrane 图书馆、Web of Science 和 Scopus 中进行了广泛的搜索，以寻找合适的英语学术论文，从创建个人资源开始，直至 2023 年 2 月 23 日。主要结果是局部复发。最初，选择了 2191 项与 nSCC 相关的研究。每项研究的信息均被检索和细分，包括发表年份、时期、患者人数、年龄、性别分布、肿瘤分期、干预类型、复发次数和随访期。结果最终入选10个独立研究（319个病灶）。莫氏显微手术是报道最多的手术方式，其次是广泛手术切除和截肢。莫氏显微手术、广泛手术切除和截肢治疗之间的局部复发率几乎相同。其他手术方法包括有限手术切除、部分消融、有限切除直至切缘清除等，复发率高达50%。结论 考虑到指骨截肢带来的功能障碍和心理困扰，功能性手术，包括莫氏显微手术和广泛手术切除，应该是无骨累及的 nSCC 的首选治疗方法。截肢仍应是涉及骨骼的非鳞状细胞癌的首选治疗方法。应避免部分切除。需要进一步研究莫氏显微手术或广泛手术切除是否是不累及骨骼的 nSCC 的更好选择。

Background Nail unit squamous cell carcinoma (nSCC) is a malignant subungual tumour. Although it has a low risk of metastasis and mortality, the tumour has a significant local recurrence rate. There is insufficient data to determine whether functional surgery is less effective than amputation for nSCC that does not involve the bone. Objectives We aimed to investigate existing data on the outcomes of functional surgery and amputation for nSCC without bone invasion. Materials and Methods We carried out an extensive search in PubMed, Embase, Cochrane Library, Web of Science, and Scopus for appropriate English-language academic papers, starting with the creation of individual resources until February 23, 2023. The main outcome was local recurrence. Initially, 2191 studies related to nSCC were selected. Information from every research study was retrieved and subdivided, comprising the year of publication, period, number of patients, age, gender distribution, tumour stage, type of intervention, number of recurrences, and follow-up period. Results Ten independent studies (319 lesions) were finally selected. Mohs micrographic surgery was the most reported surgical modality, followed by wide surgical excision and amputation. Local recurrence rates between Mohs micrographic surgery, wide surgical excision and amputation treatment were nearly identical. Other surgical methods included limited surgical excision, partial ablation, and limited excision until the clearing of margins, with recurrence rates up to 50%. Conclusions Given the functional impairment and psychological distress associated with phalanx amputation, functional surgery, including Mohs micrographic surgery and wide surgical excision , should be the preferred therapy for nSCC without bone involvement. Amputation should remain the preferred therapy for nSCC that involves the bone. Partial excision should be avoided. Further studies on whether Mohs micrographic surgery or wide surgical excision is a better option for nSCC not involving the bone are required.