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• W2895579350 abstract "To the Editor: Eccrine malignancies are rare cutaneous tumors that are incompletely described on a population level.1Tolkachjov S.N. Schmitt A.R. Muzic J.G. Weaver A.L. Baum C.L. Incidence and clinical features of rare cutaneous malignancies in Olmsted County, Minnesota, 2000 to 2010.Dermatol Surg. 2017; 43: 116-124Crossref PubMed Scopus (17) Google Scholar In addition, little information exists regarding differences in the clinical characteristics of eccrine malignancies among different demographic groups.2Unsal A.A. Patel V.R. Chung S.Y. Zhou A.H. Baredes S. Eloy J.A. Head and neck sweat gland adenocarcinoma: a population-based perspective of a rare entity.Laryngoscope. 2017; 127: 2757-2762Google Scholar The objective of this study is to elucidate trends in the incidence, clinical characteristics, and mortality of primary eccrine malignancies using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 18 registries from 2000 to 2013.3National Cancer InstituteSurveillance, Epidemiology, and End Results (SEER) Program. SEER limited-use data (1973-2013). National Cancer Institute, Bethesda, MD2014Google Scholar Patients diagnosed with malignant eccrine spiradenoma, eccrine papillary adenocarcinoma, eccrine adenocarcinoma (EA), and malignant eccrine poroma (MEP) as their first primary tumor were included in this study.4World Health Organization International Classification of Diseases for Oncology, 3rd edition (ICD-O-3). World Health Organization, Geneva, Switzerland2013Google Scholar We performed descriptive analysis, determined age-adjusted incidence rates, and used Joinpoint time-trend regression analysis to calculate an annual percent change (APC) to elucidate trends over population subsets, and calculated observed and relative 10-year age-adjusted survival rates using the Kaplan–Meier method. All analyses were performed in SEER*Stat 8.3.4 and R software, and all incidence rates are shown per 100,000 person-years. In total, 1137 patients with primary eccrine malignancies were identified in SEER 18 from 2000 to 2013 (Table I). The incidence of eccrine malignancies was significantly greater in males than females (0.12 vs 0.08; P < .0001) and the incidence was significantly lower in black patients (0.07) that white patients (0.07 vs 0.10; P < .01). The age-adjusted annual incidence of eccrine malignancies increased by 58.2% from 2000 to 2013 controlling for age, race, sex, residence, and malignancy, with an overall annual percentage change of 4.35% (P < .001). The increase in incidence was significant for males (4.40% APC), females (4.21% APC), and white patients (4.41% APC; P < .01 for all). The increase in incidence among black patients was not significant.Table IDemographics of patient sample (Surveillance, Epidemiology, and End Results 18, 2000-2013)Total (N = 1137)Male (n = 632)Female (n = 525)n (%)n (%)n (%)Age groups, y ≤198 (0.7)4 (0.6)4 (0.8) 20-3986 (7.5)51 (8.1)35 (6.7) 40-59297 (26.1)185 (29.3)112 (21.3) 60-79468 (41.2)250 (39.6)218 (41.5) ≥80279 (24.5)142 (22.5)137 (26.1)Race White938 (82.5)530 (83.9)408 (77.7) Black82 (7.2)46 (7.3)36 (6.9) Other47 (4.1)23 (3.6)24 (4.6) Unknown71 (6.2)33 (5.2)38 (7.2)Residence Metropolitan1030 (90.6)566 (89.6)464 (88.4) Rural107 (9.4)66 (10.4)41 (7.8)Malignancy Malignant eccrine spiradenoma93 (8.2)45 (7.1)48 (9.1) Eccrine papillary adenocarcinoma103 (9.1)81 (12.8)22 (4.2) Malignant eccrine poroma493 (43.4)274 (43.4)219 (41.7) Eccrine adenocarcinoma449 (39.5)232 (36.7)217 (41.3) Open table in a new tab The relative 10-year age-adjusted survival rate of eccrine malignancies was 90.84%. Observed and relative age-adjusted survival rates were different, however, across each of the 4 eccrine malignancies (Table II). Eccrine papillary adenocarcinoma had significantly greater relative age-adjusted survival than all other eccrine malignancies (P < .01), and malignant eccrine poroma had the lowest relative age-adjusted survival rate (P < .01). Increasing age was associated with increasing mortality rate (P < .01). Male (hazard radio [HR] 1.07), black (HR 1.13), and rural (HR 1.21) patients with eccrine malignancies had greater all-cause mortality when compared to female, white, and metropolitan patients, respectively (HRs 1.07, 1.13, and 1.21, respectively; P < .05 for all).Table IITen-year age-adjusted survival ratesObservedObserved SERelativeRelative SEMalignant eccrine spiradenoma63.76%5.12%80.25%9.28%Eccrine papillary adenocarcinoma90.17%5.44%97.82%5.90%Malignant eccrine poroma55.55%5.00%85.77%6.18%Eccrine adenocarcinoma66.58%3.76%92.64%2.14%SE, Standard error. Open table in a new tab SE, Standard error. This population-based study shows that the incidence of eccrine malignancies is increasing significantly and increasing age, black race, male sex, and rural residence are all associated with worse outcomes. Significant differences in incidence and mortality among demographic groups and different eccrine malignancies warrant further research regarding the biologic underpinnings of the various eccrine malignancies. Our findings also corroborate the growing literature showing differences in health care outcomes for common cutaneous malignancies with regard to the urban–rural continuum and different racial groups.5Meit M. Knudson A. Leveraging interest to decrease rural health disparities in the United States.Am J Public Health. 2017; 107: 1563-1564Google Scholar Limitations of the SEER registries include inconsistent follow-up, as well as lack of verification of individual diagnoses and under-registration of patients.6Mayer J.E. Swetter S.M. Fu T. Geller A.C. Screening, early detection, education, and trends for melanoma: current status (2007-2013) and future directions.J Am Acad Dermatol. 2014; 71 (599.e1-12)Google Scholar, 7Kosary C.L. Altekruse S.F. Ruhl J. Lee R. Dickie L. Clinical and prognostic factors for melanoma of the skin using SEER registries: collaborative stage data collection system, version 1 and version 2.Cancer. 2014; 120: 3807-3814Crossref PubMed Scopus (42) Google Scholar Better characterizing clinical differences in eccrine malignancies related to race, sex, and residence is critical in better recognizing their epidemiologic characteristics, more precisely establishing a clinical approach, and providing more comprehensive patient education." @default.
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• W2895579350 date "2019-06-01" @default.
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• W2895579350 title "Trends in the incidence and survival of eccrine malignancies in the United States: A SEER population-based study" @default.
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• W2895579350 doi "https://doi.org/10.1016/j.jaad.2018.09.043" @default.
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