Cutaneous apocrine adenocarcinoma: defining epidemiology, outcomes, and optimal therapy for a rare neoplasm.

BACKGROUND AND

OBJECTIVES

Apocrine adenocarcinoma is a rare neoplasm. There is a paucity of data on demographics and survival with no clear consensus on management of at risk lymph nodes, therefore, we analyzed a large cohort of patients identified via a national tumor registry.

METHODS

Patients ages 17-91 from 1973 to 2006 were identified in the SEER registry and excluded breast and non-cutaneous neoplasms. Data analyzed included basic demographics, survival, surgical therapy, and stage.

RESULTS

A total of 186 patients with apocrine adenocarcinoma were identified. The median age was 67 years, 76% were white and there was an equal distribution of males and females. The most common site was trunk (53%) followed by head and neck (35%). Surgery was performed on most patients (96%), either excision (50%) or wide excision (30%). Lymph node metastases were present in 69% patients undergoing node surgery. Median overall survival was 51.5 months. Positive lymph node status (P = 0.006) and metastatic disease (P < 0.001) were associated with diminished overall survival.

CONCLUSIONS

Cutaneous apocrine adenocarcinoma is a rare neoplasm. Excision is standard treatment. The most important predictor of survival in localized disease is lymph node status; therefore, sentinel lymph node biopsy could be considered in management of this disease.