Amrita Goyal1, Theodore Marghitu2, Nikhil Goyal3, Nathan Rubin4, Krishnan Patel5, Kavita Goyal6, Daniel O'Leary7, Kimberly Bohjanen6, Ian Maher6. 1. Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA. amrita.goyal@gmail.com. 2. University of Minnesota Medical School, Minneapolis, MN, USA. 3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 4. Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA. 5. Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA. 6. Department of Dermatology, University of Minnesota, 516 Delaware St SE, Minneapolis, MN, 55401, USA. 7. Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA.
Abstract
OBJECTIVE: To analyze the prognosis of cutaneous adnexal malignancies, survival relative to surgical management, and utility of lymph-node biopsy. DESIGN: Population-based study of the SEER-18 database from 1975 to 2016. PARTICIPANTS: 7591 patients with sweat gland carcinoma, hidradenocarcinoma, spiradenocarcinoma, sclerosing sweat duct tumor/microcystic adnexal tumor (SSDT/MAC), porocarcinoma, eccrine adenocarcinoma, and sebaceous carcinoma RESULTS: Five-year OS ranged from 68.0 to 82.6%, while 5-year DSS ranged from 94.6 to 99.0%. The majority of patients were treated with narrow (42.4%) or wide local excision (16.9%). DSS at 5 years showed that patients with stage IV had significantly poorer survival (50.3%) than I, II, or III (99.3%, 97.8%, and 89.0% respectively). 5-year OS was significantly higher for narrow excision (excision with < 1 cm margin, 78.5%) than observation (65.0%), excisional biopsy (66.8%), or wide local excision (WLE, 73.2%). Lymph-node biopsy was performed in a minority of cases (8.1%) and patients showed no significant difference in survival based on nodal status. The sensitivity and specificity of lymph-node biopsy for all malignancies were 46% and 80%, respectively. The PPV and NPV for that group were 0.46 and 0.80, respectively. Invasion of deep extradermal structures was a poor predictor of nodal positivity. CONCLUSIONS: These malignancies have excellent DSS. Narrow excisions demonstrate better 5-year DSS and OS compared with WLE. Lymph-node biopsy is a poor predictor of survival in advanced stage disease and utility is limited.
OBJECTIVE: To analyze the prognosis of cutaneous adnexal malignancies, survival relative to surgical management, and utility of lymph-node biopsy. DESIGN: Population-based study of the SEER-18 database from 1975 to 2016. PARTICIPANTS: 7591 patients with sweat gland carcinoma, hidradenocarcinoma, spiradenocarcinoma, sclerosing sweat duct tumor/microcystic adnexal tumor (SSDT/MAC), porocarcinoma, eccrine adenocarcinoma, and sebaceous carcinoma RESULTS: Five-year OS ranged from 68.0 to 82.6%, while 5-year DSS ranged from 94.6 to 99.0%. The majority of patients were treated with narrow (42.4%) or wide local excision (16.9%). DSS at 5 years showed that patients with stage IV had significantly poorer survival (50.3%) than I, II, or III (99.3%, 97.8%, and 89.0% respectively). 5-year OS was significantly higher for narrow excision (excision with < 1 cm margin, 78.5%) than observation (65.0%), excisional biopsy (66.8%), or wide local excision (WLE, 73.2%). Lymph-node biopsy was performed in a minority of cases (8.1%) and patients showed no significant difference in survival based on nodal status. The sensitivity and specificity of lymph-node biopsy for all malignancies were 46% and 80%, respectively. The PPV and NPV for that group were 0.46 and 0.80, respectively. Invasion of deep extradermal structures was a poor predictor of nodal positivity. CONCLUSIONS: These malignancies have excellent DSS. Narrow excisions demonstrate better 5-year DSS and OS compared with WLE. Lymph-node biopsy is a poor predictor of survival in advanced stage disease and utility is limited.
Authors: Paul N Bogner; Douglas R Fullen; Lori Lowe; Augusto Paulino; J Sybil Biermann; Vernon K Sondak; Lyndon D Su Journal: Cancer Date: 2003-05-01 Impact factor: 6.860
Authors: Joshua L Owen; Nour Kibbi; Brandon Worley; Ryan C Kelm; Jordan V Wang; Christopher A Barker; Ramona Behshad; Christopher K Bichakjian; Diana Bolotin; Jeremy S Bordeaux; Scott H Bradshaw; Todd V Cartee; Sunandana Chandra; Nancy L Cho; Jennifer N Choi; M Laurin Council; Hakan Demirci; Daniel B Eisen; Bita Esmaeli; Nicholas Golda; Conway C Huang; Sherrif F Ibrahim; S Brian Jiang; John Kim; Timothy M Kuzel; Stephen Y Lai; Naomi Lawrence; Erica H Lee; Justin J Leitenberger; Ian A Maher; Margaret W Mann; Kira Minkis; Bharat B Mittal; Kishwer S Nehal; Isaac M Neuhaus; David M Ozog; Brian Petersen; Veronica Rotemberg; Sandeep Samant; Faramarz H Samie; Sabah Servaes; Carol L Shields; Thuzar M Shin; Joseph F Sobanko; Ally-Khan Somani; William G Stebbins; J Regan Thomas; Valencia D Thomas; David T Tse; Abigail H Waldman; Michael K Wong; Y Gloria Xu; Siegrid S Yu; Nathalie C Zeitouni; Timothy Ramsay; Kelly A Reynolds; Emily Poon; Murad Alam Journal: Lancet Oncol Date: 2019-12 Impact factor: 41.316
Authors: Brandon Worley; Joshua L Owen; Christopher A Barker; Ramona Behshad; Christopher K Bichakjian; Diana Bolotin; Jeremy S Bordeaux; Scott Bradshaw; Todd V Cartee; Sunandana Chandra; Nancy Cho; Jennifer Choi; M Laurin Council; Daniel B Eisen; Nicholas Golda; Conway C Huang; Sherrif F Ibrahim; S I Brian Jiang; John Kim; Mario Lacutoure; Naomi Lawrence; Erica H Lee; Justin J Leitenberger; Ian A Maher; Margaret Mann; Kira Minkis; Bharat Mittal; Kishwer S Nehal; Isaac Neuhaus; David M Ozog; Brian Petersen; Faramarz Samie; Thuzar M Shin; Joseph F Sobanko; Ally-Khan Somani; William G Stebbins; J Regan Thomas; Valencia Thomas; David Tse; Abigail Waldman; Y Gloria Xu; Siegrid S Yu; Nathalie C Zeitouni; Tim Ramsay; Emily Poon; Murad Alam Journal: JAMA Dermatol Date: 2019-09-01 Impact factor: 10.282