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Enhanced Disease-Specific Survival Among Individuals With Malignant Adnexal Tumors of the Skin Treated With Mohs
Mitchell A Taylor1,2, Michelle Swedek1, Peter Halloran1
1School of Medicine, Creighton University, Omaha, Nebraska.
Background:
Malignant adnexal tumors of the skin are a rare group of tumors that can be locally aggressive and require surgical excision with strict margin control to achieve clearance. Given the rarity of these tumors, there is a limited understanding within the medical community regarding optimal treatment approaches.
Objective:
To examine surgical management trends and outcomes for patients diagnosed with cutaneous adnexal tumors from 2000 to 2020.
Materials And Methods:
The Surveillance, Epidemiology, and End Results database was queried to identify biopsy-proven cases of cutaneous adnexal tumors between 2000 and 2020. Clinical and disease characteristics were examined, and disease-specific survivals were compared between surgical approaches using Kaplan-Meier curves and Cox proportional hazards models.
Results:
Mohs surgery demonstrated a significant increase in utilization from 2000 to 2020 (+447.1%) and improvements in disease-specific survival (mean 231.7 months; p < .001) compared with no surgery; wide local excision exhibited no improved disease-specific survival (227.7 months; p = .070). Multivariable Cox regression further highlighted that only Mohs surgery exhibited a reduced disease-specific mortality risk compared with no surgery (adjusted HR 0.49; p = .011).
Conclusion:
Given the enhanced disease-specific survival coupled with tissue preservation strategies, Mohs surgery emerges as a promising surgical approach for the treatment of malignant adnexal tumors of the skin.
Insights
Mohs surgery significantly improved survival for malignant adnexal skin tumors from 2000-2020. This technique offers better disease-specific survival and reduced mortality risk compared to other surgical methods.
Area of Science:
- Dermatology
- Surgical Oncology
- Oncology
Background:
- Malignant adnexal tumors of the skin are rare, locally aggressive neoplasms.
- Optimal surgical management for these tumors is not well-established due to their rarity.
Purpose of the Study:
- To investigate surgical treatment trends and patient outcomes for cutaneous adnexal tumors.
- To compare the efficacy of different surgical approaches, including Mohs surgery and wide local excision.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database for biopsy-proven cases from 2000-2020.
- Analyzed clinical and disease characteristics, comparing disease-specific survival using Kaplan-Meier curves and Cox proportional hazards models.
Main Results:
- Mohs surgery utilization increased by 447.1% from 2000-2020.
- Mohs surgery significantly improved disease-specific survival (p < .001) and reduced mortality risk (adjusted HR 0.49; p = .011) compared to no surgery.
- Wide local excision did not show a significant improvement in disease-specific survival (p = .070).
Conclusions:
- Mohs surgery is a highly effective treatment for malignant adnexal tumors of the skin.
- This technique offers enhanced disease-specific survival and preserves tissue, making it a promising option.
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