Taylor Mitchell A, Swedek Michelle, Halloran Peter, Georgesen Corey, Voss Vanessa B, Wysong Ashley
School of Medicine, Creighton University, Omaha, Nebraska.
Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska.
Dermatol Surg. 2025 Jan 1;51(1):11-16. doi: 10.1097/DSS.0000000000004397. Epub 2024 Sep 11.
Malignant adnexal tumors of the skin are a rare group of tumors that can be locally aggressive and require surgical excision with strict margin control to achieve clearance. Given the rarity of these tumors, there is a limited understanding within the medical community regarding optimal treatment approaches.
To examine surgical management trends and outcomes for patients diagnosed with cutaneous adnexal tumors from 2000 to 2020.
The Surveillance, Epidemiology, and End Results database was queried to identify biopsy-proven cases of cutaneous adnexal tumors between 2000 and 2020. Clinical and disease characteristics were examined, and disease-specific survivals were compared between surgical approaches using Kaplan-Meier curves and Cox proportional hazards models.
Mohs surgery demonstrated a significant increase in utilization from 2000 to 2020 (+447.1%) and improvements in disease-specific survival (mean 231.7 months; p < .001) compared with no surgery; wide local excision exhibited no improved disease-specific survival (227.7 months; p = .070). Multivariable Cox regression further highlighted that only Mohs surgery exhibited a reduced disease-specific mortality risk compared with no surgery (adjusted HR 0.49; p = .011).
Given the enhanced disease-specific survival coupled with tissue preservation strategies, Mohs surgery emerges as a promising surgical approach for the treatment of malignant adnexal tumors of the skin.
皮肤恶性附属器肿瘤是一组罕见的肿瘤，具有局部侵袭性，需要进行手术切除并严格控制切缘以实现清除。鉴于这些肿瘤的罕见性，医学界对最佳治疗方法的了解有限。
研究2000年至2020年诊断为皮肤附属器肿瘤患者的手术治疗趋势和结果。
查询监测、流行病学和最终结果数据库，以识别2000年至2020年间经活检证实的皮肤附属器肿瘤病例。检查临床和疾病特征，并使用Kaplan-Meier曲线和Cox比例风险模型比较不同手术方法之间的疾病特异性生存率。
与未手术相比，Mohs手术在2000年至2020年间的使用率显著增加（+447.1%），疾病特异性生存率有所提高（平均231.7个月；p < .001）；广泛局部切除的疾病特异性生存率没有提高（227.7个月；p = .070）。多变量Cox回归进一步强调，与未手术相比，只有Mohs手术表现出降低的疾病特异性死亡风险（调整后HR 0.49；p = .011）。
鉴于疾病特异性生存率提高以及组织保存策略，Mohs手术成为治疗皮肤恶性附属器肿瘤的一种有前景的手术方法。
