Primary cutaneous mucinous carcinoma: a systematic review and meta-analysis of outcomes after surgery.
OBJECTIVE
Evidence-based treatment guidelines are not available for primary cutaneous mucinous carcinoma (PCMC).


OBJECTIVE
To assess outcomes associated with surgical treatment of PCMC.


METHODS
MEDLINE, Cumulative Index to Nursing and Allied Health, and Embase from 1952 to 2010. Search terms were "primary cutaneous mucinous carcinoma," "primary mucinous adenocarcinoma of the skin," "primary mucinous sweat-gland carcinoma," and "endocrine mucin-producing sweat gland carcinoma."


METHODS
Articles describing primary data on treatment (ie, case reports, case series, and cohort studies) of any patients with PCMC. A total of 116 articles were identified, with 90 of these assessed for eligibility and 87 used for final analysis.


METHODS
Each case was verified to be of primary cutaneous origin by 2 observers. Histopathologic descriptions were confirmed to be consistent with PCMC. Extracted fields included age, sex, race, lesion duration, tumor diameter, method of treatment, follow-up, and whether the lesion recurred or metastasized.


METHODS
Outcomes were dichotomized into good and bad depending on the presence of recurrence or metastasis during follow-up. Multivariate logistic regression analysis was performed to determine significant factors for predicting bad outcomes. RESULTS One hundred fifty-nine cases of PCMC, of whom 54.7% were male and 77.2% were white, with mean (SD) age 63.5 (13.2) years, were analyzed. Most had been treated with traditional surgical excision (85.5%), with only 9.4% of cases treated with Mohs surgery. Older (odds ratio [OR], 0.93; P = .04) and Asian (OR, 0.02; P = .01) patients had relatively better postsurgical outcomes. Larger tumors (OR, 6.71; P = .14), those persistent for longer prior to surgery (OR, 1.02; P = .11), and those located on the trunk (OR, 103.24; P = .005) also were associated with poorer outcomes. Limitations included reliance on case report data.


CONCLUSIONS
Patient demographic characteristics and tumor-specific features may provide predictive information regarding the risk of postsurgical recurrence and metastasis after treatment of PCMC.
Division of Dermatology, Loyola University, Chicago, Illinois.
Loebat
L
Kamalpour
Garden City Hospital, Garden City, Michigan.
Renata T
RT
Brindise
Department of Dermatology, Northwestern University, Chicago, Illinois.
Michael
M
Nodzenski
Department of Dermatology, Northwestern University, Chicago, Illinois.
Daniel Q
DQ
Bach
Department of Dermatology, Emory University, Atlanta, Georgia5Center for Research and Grants, Baptist Health South Florida, Miami, Florida.
Emir
E
Veledar
Department of Dermatology, Northwestern University, Chicago, Illinois.
Murad
M
Alam
D002288:Adenocarcinoma, Mucinous / Q000208:ethnology / Q000556:secondary / Q000601:surgery*; D000367:Age Factors; D006801:Humans; D015580:Mohs Surgery; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012878:Skin Neoplasms / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome