title: Cutaneous apocrine adenocarcinoma: defining epidemiology, outcomes, and optimal therapy for a rare neoplasm.
abstract: OBJECTIVE
  Apocrine adenocarcinoma is a rare neoplasm. There is a paucity of data on demographics and survival with no clear consensus on management of at risk lymph nodes, therefore, we analyzed a large cohort of patients identified via a national tumor registry.
  
  
  METHODS
  Patients ages 17-91 from 1973 to 2006 were identified in the SEER registry and excluded breast and non-cutaneous neoplasms. Data analyzed included basic demographics, survival, surgical therapy, and stage.
  
  
  RESULTS
  A total of 186 patients with apocrine adenocarcinoma were identified. The median age was 67 years, 76% were white and there was an equal distribution of males and females. The most common site was trunk (53%) followed by head and neck (35%). Surgery was performed on most patients (96%), either excision (50%) or wide excision (30%). Lymph node metastases were present in 69% patients undergoing node surgery. Median overall survival was 51.5 months. Positive lymph node status (P = 0.006) and metastatic disease (P < 0.001) were associated with diminished overall survival.
  
  
  CONCLUSIONS
  Cutaneous apocrine adenocarcinoma is a rare neoplasm. Excision is standard treatment. The most important predictor of survival in localized disease is lymph node status; therefore, sentinel lymph node biopsy could be considered in management of this disease.
authors.affiliation: Division of Surgical Oncology, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Hollowell
authors.forename: Steven C
authors.initials: SC
authors.lastname: Agle
authors.forename: Emmanuel E
authors.initials: EE
authors.lastname: Zervos
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Fitzgerald
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000401:mortality* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001050:Apocrine Glands; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000601:surgery; D015996:Survival Rate; D013544:Sweat Gland Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D055815:Young Adult