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Publications

Journal Article Ahead of print

PubMed: 41935490 DOI: 10.1016/j.ejca.2026.116710

Prognostic classification of skin adnexal carcinomas: Results from a prospective study of 980 patients in the French CARADERM network.

Eur J Cancer 239:116710

Authors: Robin Zagala, Stephane Dalle, Brigitte Balme, Emilie Gerard, Marie-Laure Jullie, Marie Crinquette, Philippe Saiag, Benjamin Bonsang, Cecile Pages Laurent, Laurence Lamant, Caroline Gaudy-Marqueste, Nicolas Macagno, Celeste Lebbe, Bénédicte Oulès, Pierre Sohier, Ouidad Zehou, Nicolas Ortonne, Jean-Philippe Arnault, Alice Seris, Léa Dousset, Bernard Cribier, Thibault Kervarrec, Helene Behal, Laurent Mortier, Maxime Battistella, Thomas Jouary

Affiliations

  • Dermatology department, University Hospital of Bordeaux, Bordeaux, France.
  • Dermatology department, Hospices Civils de Lyon, Pierre Bénite, France; Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.
  • Pathology department, Hospices Civils de Lyon, Pierre Bénite, France.
  • Dermatology department, University Hospital of Bordeaux, Bordeaux, France.
  • Pathology department, University Hospital of Bordeaux, Pessac, France.
  • Pathology Department, University Hospital of Lille, Lille, France.
  • Department of General and Oncologic Dermatology, Ambroise Paré hospital, APHP, Boulogne-Billancourt, France; EA 4340 "Biomarkers in cancerology and hemato-oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France.
  • Pathology Department, Ambroise Paré hospital, APHP, Boulogne-Billancourt, France.
  • Dermatology department, IUCT Oncopole, Toulouse, France.
  • Pathology Department, University Hospital of Toulouse, Toulouse, France.
  • Dermatology department, APHM La Timone, Marseille, France.
  • Pathology department, APHM La Timone, Marseille, France.
  • Dermato-Oncology and CIC, Cancer Institute APHP Nord, Université Paris Cité, Paris, France; INSERM U1342 - Equipe 1 - CNRS EMR8000, Saint Louis Hospital, Paris, France.
  • Dermatology department, Cochin hospital, APHP, Paris, France.
  • Pathology department, Cochin hospital, APHP, Paris, France.
  • Dermatology department, Henri Mondor hospital, APHP, Créteil, France.
  • Pathology department, Henri Mondor hospital, APHP, Créteil, France.
  • Dermatology department, University Hospital of Amiens-Picardie, Amiens, France.
  • Clinical Research Unit, Francois Mitterrand Hospital, Pau, France.
  • Dermatology department, University Hospital of Strasbourg, Strasbourg, France.
  • Pathology department, University Hospital of Tours, Tours, France.
  • Department of Biostatistics, University Hospital of Lille, Lille, France.
  • Dermatology department, University Hospital of Lille, Lille, France; Inserm U1189, Lille University, Lille, France.
  • Pathology department, AP-HP Hôpital Saint-Louis, Cancer Institute APHP Nord-Université Paris Cité, Paris, France; INSERM U1342, Université Paris Cité, Paris, France.
  • Dermatology department, Francois Mitterrand Hospital, Pau, France.

Abstract

BACKGROUND

Skin adnexal carcinomas (SAC) comprise a rare and heterogeneous group of malignancies with variable prognosis. Due to the lack of established guidelines for initial staging and follow-up, this study aimed to analyse recurrence risks across SAC subtypes to provide a framework for subtype-specific treatments options and follow-up.

METHODS

This nationwide multicentre prospective study, using the CARADERM database, included patients diagnosed with primary and localised SAC between March 2014 and March 2024. Subtypes with fewer than 15 cases were excluded from the prognostic analysis. Recurrence was classified as local, regional, or distant, with a three-year follow-up endpoint. Recurrence risks were stratified as low (<5%), moderate (5-15%), or high (≥15%) for local and regional recurrences and as low (0%), moderate (0-5%), or high (≥5%) for distant recurrences.

RESULTS

Among 980 eligible patients, distinct recurrence patterns were identified across subtypes. Subtypes with high global recurrence risk included adnexal carcinomas NOS, apocrine carcinomas, mucinous adenocarcinomas and squamoid eccrine ductal carcinomas, with three-year cumulative recurrence rate of 29.3%. In contrast, low-risk subtypes such as low-grade trichoblastic carcinomas, pilomatrical carcinomas, proliferating trichilemmal tumor and digital papillary adenocarcinomas, exhibited a global recurrence rate of 1.5%. Local, regional, and distant recurrence risks varied among subtypes, emphasising their heterogeneous clinical behavior.

CONCLUSION

This is the first prospective multicentre study to define recurrence-based risk stratification across SAC subtypes. These findings underscore the need for subtype-specific strategies and provide the foundation for evidence-based staging and follow-up algorithms for rare skin carcinomas.

MeSH

Skin, Adenocarcinoma, Mucinous, Neoplasms, Adenocarcinoma, Classification, Prospective Studies