Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuoku, Tokyo, 104-0045, Japan.
Department of Dermatology, Faculty of Medicine, Saga University, Saga, Japan.
Int J Clin Oncol. 2023 Dec;28(12):1690-1696. doi: 10.1007/s10147-023-02420-z. Epub 2023 Oct 6.
Cutaneous apocrine carcinoma (CAC) is a rare adnexal carcinoma. Limited data exists on the demographics and overall survival (OS) of patients with CAC; thus, there is no consensus on surgical management. This study aimed to examine demographic and survival data of patients with CAC to determine optimal surgical management.
A single-center retrospective cohort study was conducted at the National Cancer Center Hospital in Tokyo between 2005 and 2022. Patients with a histologically-confirmed CAC diagnosis were identified and data on patient demographics, OS, and lymph node (LN) status were gathered.
Thirty-two patients were included (median age, 65.5 years; male-female ratio, 15:1). The most common involvement site was the axilla (87.5%). Of the nine patients in the clinical local stage, pathological LN metastases were found in five patients. Either pathological LN or distant metastases were present in 75% of the patients at initial diagnosis. The most common initial surgical treatments included wide local excision and complete LN dissection. Across cohorts, the median OS was 39 months. Patients with ≥ 4 LN metastases had reduced recurrence-free survival and OS compared to those with ≤ 3 LN metastases (p = 0.042, p = 0.041, respectively). The OS was not remarkably different between patients who did and did not receive postoperative radiation therapy.
Since CAC has a high rate of LN metastasis-and the number of LN metastases is a significant prognostic factor-LN evaluation should be considered for patients with CAC as initial treatment. Nonetheless, ≥ 4 LN metastases can be a poor prognostic factor for CAC.
皮肤大汗腺癌（CAC）是一种罕见的附属器癌。关于 CAC 患者的人口统计学和总生存（OS）数据有限，因此，对于手术管理尚未达成共识。本研究旨在检查 CAC 患者的人口统计学和生存数据，以确定最佳手术管理。
在东京国家癌症中心医院进行了一项单中心回顾性队列研究，时间范围为 2005 年至 2022 年。确定了组织学确诊为 CAC 的患者，并收集了患者人口统计学、OS 和淋巴结（LN）状态的数据。
共纳入 32 例患者（中位年龄 65.5 岁；男女比例 15:1）。最常见的受累部位是腋窝（87.5%）。在 9 例临床局部分期患者中，5 例存在病理 LN 转移。75%的患者在初始诊断时即存在病理 LN 或远处转移。最常见的初始手术治疗包括广泛局部切除和完全 LN 清扫。在所有队列中，中位 OS 为 39 个月。与 LN 转移数≤3 的患者相比，LN 转移数≥4 的患者的无复发生存率和 OS 降低（p=0.042，p=0.041）。是否接受术后放疗对 OS 无显著影响。
由于 CAC 的 LN 转移率较高，且 LN 转移数是一个重要的预后因素，因此 CAC 患者的初始治疗应考虑进行 LN 评估。然而，LN 转移数≥4 可能是 CAC 的一个不良预后因素。
