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Surgical Margin Status is an Independent Predictor of Overall Survival in Sebaceous Carcinoma


Sebaceous carcinoma patients with positive surgical margins were found to have a poorer survival. Surgical margin status in sebaceous carcinoma was also found to be an independent predictor of overall survival after adjusting for covariates

Clinical Pearls

  • This research letter investigated the prognostic impact of positive surgical margins in sebaceous carcinoma using the National Cancer Database

  • With data from 2,039 patients with sebaceous carcinoma, 150 were found to have positive surgical margins. Kaplan-Meier analysis and Multivariate Cox proportional hazards analysis were used to better understand the data.

  • Sebaceous carcinoma patients with positive surgical margins were found to have a poorer survival. Surgical margin status in sebaceous carcinoma was also found to be an independent predictor of overall survival after adjusting for covariates


Discussion:

In this article, Maloney et. al focused on better understanding risk factors and the prognostic impact of positive surgical margins in sebaceous carcinoma. The authors used the National Cancer Database to access information for patients diagnosed with sebaceous carcinoma from 2004-2007. Patients were only included if they were clinically node negative and did not have missing data.

2,039 patients initially met the study’s criteria, however, only 150 (7.4%) had positive surgical margins. Following Kaplan-Meier analysis, it was found that patients with positive surgical margins had poorer survival (54.7% vs 70.4% in patients with negative margins) Additionally, following Multivariate Cox Proportional hazards analysis, it was found that surgical margin status was an independent predictor of overall survival in sebaceous carcinoma.

Factors found to be associated with positive surgical margins were lip/ear location, periocular location, tumor size >2 cm, low facility volume, and older age. Interestingly, adjuvant radiation therapy was not found to be associated with improved survival.

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