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Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases
Author(s) -
Giridhar Prashanth,
Kashyap Lakhan,
Mallick Supriya,
Dutt Upadhyay Ashish,
Rath Goura K.
Publication year - 2020
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14739
Subject(s) - medicine , sebaceous carcinoma , surgery , radiation therapy , neck dissection , hazard ratio , cohort , adjuvant therapy , carcinoma , confidence interval , chemotherapy
Background Extraocular sebaceous carcinoma (EOSC) is an aggressive malignancy of the sebaceous gland. Surgery is considered the cornerstone of treatment, but there is lack of clarity about extent and adjuvant treatment. Methods We conducted a systematic review and analysis of individual patient data of all published cases of EOSC to look into demography, pattern of care, importance of type of surgery, and other adjuvant treatment and survival outcome. A search of PubMed and Google Scholar was done with the key words sebaceous carcinoma, extraocular sebaceous carcinoma, and Muir‐Torre syndrome till December 2017. The data were compiled in an Excel chart and analyzed using SPSS IBM software. Results Data of 206 patients were retrieved. Median age at presentation was 65 years (range: 11–96 years). Surgery was performed in all except 13 patients. Of these 13, eight were deemed inoperable for extensive disease, and five had metastatic disease. Median PFS and OS for the entire cohort were 84 months (95% CI: 10–158 months) and 92 months (95% CI: 59–126 months). Univariate analysis revealed significantly poor survival for patients with a metastatic disease, regional nodal metastasis, and those with Mohs micrographic or incomplete surgery. Conclusion EOSC is a disease of elderly patients with good prognosis. Complete surgery with regional lymph node dissection is standard treatment. The role of adjuvant radiotherapy is debatable but can be considered in patients with incomplete surgery or high‐risk factors.