Sentinel lymph node biopsy predicts systemic recurrence in digital papillary adenocarcinoma
Meredith K Bartelstein1, Eugenia Schwarzkopf2, Klaus J Busam3
1Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Journal of Surgical Oncology
|January 18, 2021
Summary
Sentinel lymph node biopsy (SLNB) in digital papillary adenocarcinoma (DPA) identified metastatic disease in 17% of patients. A positive SLNB appears to predict systemic recurrence in this rare cancer.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Oncology
Background:
- Digital papillary adenocarcinoma (DPA) is a rare and aggressive sweat gland neoplasm.
- DPA has the potential for local, regional, and distant recurrence.
- The prognostic value of sentinel lymph node biopsy (SLNB) in DPA is not well-established.
Purpose of the Study:
- To evaluate the role of SLNB in predicting the outcome of patients with upper extremity DPA.
- To assess the association between SLNB status and recurrence patterns in DPA.
Main Methods:
- Retrospective review of medical records for patients with biopsy-proven upper extremity DPA.
- Descriptive statistics and Fisher's exact test were used for data analysis.
- Analysis of SLNB status and recurrence data in a cohort of 21 patients.
Main Results:
- Of 21 patients, 18 underwent SLNB, with 17% (3 patients) testing positive for nodal metastasis.
- At a median follow-up of 53 months, no local recurrences were observed.
- Two systemic recurrences occurred, and both were in patients with a positive SLNB. Patients with negative SLNB showed no evidence of metastasis or recurrence.
- A statistically significant association was found between positive SLNB and recurrence (P = .02).
Conclusions:
- SLNB is a valuable tool in staging DPA, identifying metastatic disease in 17% of cases.
- A positive SLNB result in DPA appears to be a significant predictor of systemic recurrence.
- Further investigation is warranted to confirm these findings in larger cohorts.
