AI Article Synopsis

  • Adnexal neoplasms are typically excised using standard local excision or Mohs micrographic surgery, especially in high-risk areas like the head and neck, due to their tendency for subclinical extension.
  • A study analyzed 4,402 cases of cutaneous adnexal malignancies from 2004 to 2019, finding that tumors in the head and neck were more likely to have positive surgical margins compared to those in the trunk and extremities.
  • The research concluded that certain adnexal tumor types, especially those on the head and neck, show a higher rate of positive margins and poorer survival rates, indicating the potential benefit of Mohs micrographic surgery for better outcomes.

Article Abstract

Background: It is recommended to excise adnexal neoplasms with standard local excision or Mohs micrographic surgery (MMS), although many occur on high-risk sites such as the head and neck (H&N) and exhibit subclinical extension. Minimal evidence exists on the efficacy of standard excisions for these tumors.

Objective: To evaluate the rate of positive surgical margins after standard excision of adnexal tumors.

Methods: Retrospective cohort study of cutaneous adnexal malignancies from the National Cancer Database diagnosed from 2004 to 2019.

Results: The authors identified a total of 4,402 cases treated with standard excision. Tumors on the H&N were approximately twice as likely as those on the trunk and extremities (T&E) to be excised with positive margins (odds ratio 2.146, p < .001), with the highest estimated rate for eccrine adenocarcinoma (12.1%, SE: 2.3%). The subtype with the highest positive margin rate on the T&E was microcystic adnexal carcinoma (8.0%, SE: 2.9). Positive margins were associated with poorer overall survival on multivariable survival analysis (hazard ratio 1.299, p = .015).

Conclusion: The authors present subtype- and site-specific positive margin rates for adnexal tumors treated with standard excision, which suggest that tumors on the H&N and some T&E subtypes, should be considered for MMS.

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Source
http://dx.doi.org/10.1097/DSS.0000000000003887DOI Listing

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