Surgical management and lymph-node biopsy of rare malignant cutaneous adnexal carcinomas: a population-based analysis of 7591 patients

Amrita Goyal, Theodore Marghitu, Nikhil Goyal, Nathan Rubin, Krishnan Patel, Kavita Goyal, Daniel O’Leary, Kimberly Bohjanen, Ian Maher

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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.

Original languageEnglish (US)
Pages (from-to)623-632
Number of pages10
JournalArchives of Dermatological Research
Issue number8
Early online dateSep 23 2020
StatePublished - Sep 2021

Bibliographical note

Funding Information:
Research reported in this publication was supported by NIH Grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota, and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.


  • Adnexal carcinoma
  • Adnexal neoplasm
  • Eccrine adenocarcinoma
  • Eccrine carcinoma
  • Hidradenocarcinoma
  • Microcystic adnexal tumor
  • Porocarcinoma
  • Sclerosing sweat duct tumor
  • Sebaceous adenocarcinoma
  • Sebaceous carcinoma
  • Spiradenocarcinoma
  • Sweat gland carcinoma


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