Sebaceous Carcinoma: A Retrospective Multicenter Analysis of 213 Cases

Background: Sebaceous carcinoma (SC) is a rare malignant cutaneous malignancy. Methods: A multicenter retrospective study of 213 German patients with SC diagnosed between 2008 and 2024 was conducted. Data were extracted from the Baden-Württemberg Cancer Registry. Cases were separated into ocular and extraocular SC. Their demographic, clinical, and treatment-related characteristics were compared and influences on overall survival (OS) analyzed. Results: Most patients were elderly (median age: 79 years), with a male-to-female ratio of 2:1. Extraocular SC was more common in men, while ocular SC was more frequent in women. Most tumors were diagnosed at stage I, and microscopically controlled excision was the primary treatment modality (81.4%). Sentinel lymph node biopsy (2.3%), lymph node dissection (1.9%) and systemic therapy (1.4%) were only documented in a minority of cases. Survival analysis (median follow-up 3.2 years) revealed a median OS of 61.4 months in the entire cohort. No significant survival difference was observed between ocular and extraocular SC (64.8 vs. 53.7 months; p = 0.490), and multivariable analysis confirmed no prognostic impact of tumor localization (HR 1.4, 95% CI 0.85-2.4). Age was the only independent predictor of outcome, with strongly increased risk in patients aged 70-79 years (HR 4.4, 95% CI 1.01-19.2) and ≥80 years (HR 16.1, 95% CI 3.91-66.1). Prior malignancies, including MTS-like tumors and hematological neoplasms, were not independently associated with overall survival. Conclusions: In this multicenter cohort, sebaceous carcinoma showed no survival difference between ocular and extraocular disease, with age emerging as the main independent prognostic factor. Prior malignancies and tumor characteristics, including histologic grade, were not independently associated with outcome. Microscopically controlled excision appears to be an effective treatment option.