Boston University, Boston, MA, USA.
Am J Surg. 2011 May;201(5):695-9. doi: 10.1016/j.amjsurg.2010.04.015. Epub 2010 Sep 20.
Malignant eccrine spiradenoma is an aggressive sweat gland tumor with poorly understood behavior and no currently accepted therapeutic regimen.
An individual patient data meta-analysis with Kaplan–Meier survival curves was performed on 72 reported cases of malignant eccrine spiradenoma.
In 35 patients with no distant metastasis, local resection resulted in 100% disease-free survival. Of 7 patients with lymph node but no distant metastasis treated with surgical resection and lymph node dissection, 6 patients remained disease-free at final follow-up evaluation. For the 24 cases with confirmed distant metastatic disease, patient survival did not significantly differ between local resection and surgery with adjuvant chemoradiotherapy (P = .8763).
Heightened awareness is recommended among surgeons likely to treat this entity. An aggressive surgical approach is supported in the absence of metastasis. When lymph nodes are not clinically involved, sentinel node may have a role followed by lymph node dissection in patients with a positive node.
恶性小汗腺螺旋腺瘤是一种侵袭性的汗腺肿瘤，其行为难以理解，目前也没有被接受的治疗方案。
对 72 例恶性小汗腺螺旋腺瘤的病例进行了个体患者数据的荟萃分析，并绘制了 Kaplan-Meier 生存曲线。
在 35 例无远处转移的患者中，局部切除的无疾病生存率为 100%。7 例淋巴结转移但无远处转移的患者，接受手术切除和淋巴结清扫术治疗，其中 6 例在最终随访评估时仍无疾病。对于 24 例确诊有远处转移的病例，局部切除与手术加辅助放化疗的患者生存率无显著差异（P=.8763）。
建议可能治疗这种疾病的外科医生提高警惕。在没有转移的情况下，建议采取积极的手术方法。当淋巴结无临床受累时，前哨淋巴结可能具有作用，然后对阳性淋巴结患者进行淋巴结清扫。
