Malignant Cutaneous Adnexal Tumors and Role of SLNB
| Autor: | Alessandra Storino, Nicholas E. Tawa, Reed E. Drews |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms medicine.medical_treatment Kaplan-Meier Estimate Risk Assessment Amputation Surgical Metastasis 03 medical and health sciences 0302 clinical medicine Papillary adenocarcinoma Surgical oncology Interquartile range medicine Mohs surgery Humans Survival rate Aged Retrospective Studies Sentinel Lymph Node Biopsy business.industry Wide local excision Middle Aged Mohs Surgery medicine.disease Lymphatic disease Survival Rate Lymphatic Metastasis 030220 oncology & carcinogenesis Lymph Node Excision Female Neoplasms Adnexal and Skin Appendage 030211 gastroenterology & hepatology Surgery Radiology Neoplasm Recurrence Local business |
| Zdroj: | Journal of the American College of Surgeons. 232:889-898 |
| ISSN: | 1072-7515 2001-2020 |
| Popis: | Background Malignant cutaneous adnexal tumors (MCATs) are rare and their natural history is poorly understood. Available literature indicates aggressive behavior with a significant risk of metastasis. Study Design Retrospective review of our institutional surgical oncology databases was performed for patients diagnosed with MCATs (2001-2020). We hypothesized that most patients have a low risk of lymph node involvement, recurrence, and death. Kaplan-Meier statistical analysis was used to assess risk of recurrence and 5-year survival. Results We identified 41 patients diagnosed with MCATs (median age 59 years, 68% were men). Most patients had long-standing cutaneous lesions (median 24 months) and no palpable adenopathy. Most patients had stage I or II disease (98%). Primary tumors were treated with wide local excision (n = 28 [68%]), Mohs surgery (n = 5 [12%]), or amputation (n = 8 [19%]). Of 25 patients who underwent SLNB (61%), 1 had lymphatic metastasis. These include apocrine carcinoma (1 of 3), digital papillary adenocarcinoma (0 of 8), porocarcinoma (0 of 4), and additional MCAT sub-types (0 of 10). Three patients (7%) had disease recurrence at a median interval of 3.6 years (interquartile range 1.5 to 4.4 years). Five patients (12%) died at a median interval of 7 years (interquartile range 6.7 to 9.2 years), but only 1 patient was known to have succumbed to MCAT. Overall 5-year survival rate was 96% (95% CI, 75% to 99%). Conclusions Despite the historical impression that MCATs have a high metastatic potential, most patients have low recurrence rates and excellent 5-year survival rates. Lymphatic disease identified after SLNB in early-stage tumors is rare and the value of this staging procedure in MCAT remains unclear. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|