Cutaneous metastases from different internal malignancies: a clinical and prognostic appraisal

Cutaneous metastases are perceived as a sign of advanced disease and are regarded as a grave prognostic indicator. In addition, few reports have focused on the cutaneous metastasis profiles of Asian patients.

We seek to analyse the clinical and prognostic characteristics of cutaneous tumour metastases in a Taiwanese medical centre.

Clinical records from Kaohsiung Medical University Hospital over the last 20 years (1986-2006) were reviewed, and cases of biopsy-proven cutaneous metastases from internal malignancies identified. Survival rates were evaluated using the Kaplan-Meier method and compared by the log-rank test. The Cox proportional hazards model was used for univariate analysis to determine the risk of mortality among different groups.

A total of 141 cases of cutaneous metastases were identified. The clinical profiles were similar to those from western countries, although the frequencies of primary tumours were different. The duration of survival was usually short following diagnosis of cutaneous metastases, but prognosis is significantly better in breast cancer patients with metastases. Moreover, the survival was even longer for breast cancer patients when the metastasis was confined to the skin.

The risk of skin metastases depends largely on the characteristics of tumour cells, which is similar among different ethnic groups. In terms of prognosis, a subset of breast cancer patients has superior prognosis, even among breast cancer patients with stage IV disease. Physicians should consider this finding in clinical situations to avoid possible misinformation about the prognosis of the disease.