Treatment strategy for cutaneous apocrine carcinoma

Cutaneous apocrine carcinoma (CAC) is a rare adnexal carcinoma with only scattered reports about long-term follow-up. The aim of this study is to demonstrate clinical findings in the prognosis of CAC and discuss the treatment procedure.

The subjects were nine patients with a histological diagnosis of CAC who underwent wide excision and regional lymph node dissection as the initial treatment at Shizuoka Cancer Center Hospital. We examined the gender, age, site of involvement, additional treatment to prevent recurrence/metastasis, additional treatment after metastasis, and the follow-up data of the study patients. Then, we calculated the recurrence and 5-year (overall/recurrence-free) survival rates.

The men-to-women ratio was 8:1. The patients ranged in age from 47 to 81 years (median, 67 years). The primary lesion was in the axilla in five patients and in the vulva in the other four patients. The follow-up period ranged from 9 to 204 months (median, 44 months). The recurrence-free 5-year survival rate was 63 %, and the overall 5-year survival rate was 75 %.

We recommend wide local excision for a primary lesion and prophylactic regional lymph node dissection at initial therapy because of the high frequency of regional metastasis of CAC. Although CAC responds poorly to chemotherapy and radiotherapy, adjuvant radiotherapy may be used in advanced local or regional disease.