Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Dermatol Ther. 2021 Jan;34(1):e14559. doi: 10.1111/dth.14559. Epub 2020 Dec 3.
Studies on microcystic adnexal carcinoma (MAC) survival rates have been limited. This effort examines the association of patient demographics, treatment modalities, and tumor stage with overall survival (OS) in patients with MAC of the head and neck. All cases of MAC with primary sites of the skin of the head and neck, confirmed histologically, and diagnosed from 2004 to 2016 in the National Cancer Database, were analyzed. We utilized Kaplan-Meier and Cox proportional-hazard models to analyze the characteristics and survival outcomes of the 415 cases that met the criteria. The mean age of diagnosis was 63.8 years (SD ±15.8). Mean OS was 10.8 years with 5- and 10-year OS being 81.0% and 68.0%, respectively. Women were more frequently affected (59.0%; P < .001). Stand-alone primary site surgery was the most common treatment (81.4%): 15.9% of patients were treated with postexcision radiation therapy (RT). 18.3% were treated with RT with or without surgery and/or chemotherapy. RT was independently associated with a decreased hazard of death (HR = 0.23; P = .044). MAC of the head and neck disproportionately affects whites, is more common in women, and has the potential to metastasize. Surgical excision is the commonest treatment; our study shows benefit from judicious RT.
关于微囊性附件癌（MAC）生存率的研究一直有限。本研究旨在探讨患者人口统计学、治疗方式和肿瘤分期与头颈部 MAC 患者总生存率（OS）的关系。分析了 2004 年至 2016 年间国家癌症数据库中所有头颈部皮肤原发部位、经组织学证实和诊断为 MAC 的病例。我们利用 Kaplan-Meier 和 Cox 比例风险模型分析了符合标准的 415 例病例的特征和生存结果。诊断时的平均年龄为 63.8 岁（SD ±15.8）。平均 OS 为 10.8 年，5 年和 10 年 OS 分别为 81.0%和 68.0%。女性患者更为常见（59.0%；P<.001）。单纯的原发部位手术是最常见的治疗方法（81.4%）：15.9%的患者接受了切除后放疗（RT）。18.3%的患者接受了 RT 联合或不联合手术和/或化疗。RT 与死亡风险降低独立相关（HR=0.23；P=0.044）。头颈部 MAC disproportionately 影响白人，在女性中更为常见，并有转移的潜力。手术切除是最常见的治疗方法；我们的研究表明，合理的 RT 有益。
