Department of Dermatology, Stanford University Medical Center, Redwood City, California.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
Dermatol Surg. 2023 Dec 1;49(12):1122-1127. doi: 10.1097/DSS.0000000000004016. Epub 2023 Nov 14.
Sebaceous carcinoma (SC) is a rare, potentially recurrent, and life-threatening cutaneous malignancy that can be associated with Muir-Torre syndrome (MTS), a DNA mismatch repair-driven genodermatosis. Earlier studies examining factors associated with recurrence have focused on periocular tumors only.
Examine outcomes of SC and identify factors associated with recurrence.
Retrospective study from 2 tertiary care centers.
Sixty-seven cases from 63 patients were identified, including 7 cases of MTS and 13 arising in the context of immunosuppression. Fifty-five cases (82.1%) were treated with complete circumferential peripheral and deep margin assessment (CCPDMA) methods. Five recurrences developed during the postoperative period. On univariate analysis, periocular location (odds ratio [OR] 7.6, p = .0410), and lesion size ≥2 cm (OR 9.6, p = .005) were associated with recurrence, whereas CCPDMA (OR 0.052, p = .0006) was inversely associated with recurrence. On multivariate analysis, only lesion size ≥2 cm (OR 9.6, p = .0233) and CCPDMA approaches (OR 0.052, p = .007) were significant.
Non-complete circumferential peripheral and deep margin assessment methods and large lesion size were independent risk factors predicting recurrence, whereas anatomic subtype and MTS status were not. These findings can assist in identifying SC cases that may benefit from more aggressive treatment and closer surveillance.
皮脂腺癌(SC)是一种罕见的、具有潜在复发性且危及生命的皮肤恶性肿瘤,可能与 Muir-Torre 综合征(MTS)有关,后者是一种 DNA 错配修复驱动的遗传性皮肤病。早期研究检查与复发相关的因素仅集中在眼周肿瘤。
检查 SC 的结果并确定与复发相关的因素。
回顾性研究来自 2 家三级护理中心。
从 63 名患者中确定了 67 例病例,包括 7 例 MTS 和 13 例发生在免疫抑制背景下。55 例(82.1%)采用完全环形外周和深部边缘评估(CCPDMA)方法进行治疗。术后期间发生了 5 次复发。单因素分析中,眼周位置(比值比[OR]7.6,p =.0410)和病变大小≥2 cm(OR 9.6,p =.005)与复发相关,而 CCPDMA(OR 0.052,p =.0006)与复发呈负相关。多因素分析中,只有病变大小≥2 cm(OR 9.6,p =.0233)和 CCPDMA 方法(OR 0.052,p =.007)具有显著意义。
非完全环形外周和深部边缘评估方法以及大病变大小是预测复发的独立危险因素,而解剖亚型和 MTS 状态不是。这些发现有助于识别可能受益于更积极治疗和更密切监测的 SC 病例。