Microcystic adnexal carcinoma of the skin: The role of adjuvant radiotherapy
Bibliographic record
Abstract
INTRODUCTION: Microcystic adnexal carcinoma (MAC) is a rare cutaneous tumour where the role of radiotherapy remains undefined. We contrast our institutional experience with current literature, define the local control rate and suggest a role for adjuvant radiotherapy in the treatment of this cancer. METHODS: From 1992-2008, a retrospective review was undertaken for MAC treated with curative intent involving surgery and adjuvant radiotherapy at the Royal Brisbane Hospital and Mater Hospital Brisbane. Clinical, pathologic and treatment details as well as patterns of recurrence were analysed. RESULTS: Fourteen cases of MAC received local excision and adjuvant radiotherapy. The median age was 71 years old, with nine of the cases in men. All cases occurred in the head and neck region with mean tumour size of 20.5 mm and mean depth of invasion of 9.9 mm. Peri-neural invasion occurred in 56% of cases and 69% had positive surgical margins. Various adjuvant radiotherapy schedules were used to treat the primary site resulting in a crude local control rate of 93%. Primary and nodal relapses were subsequently salvaged with further treatment. CONCLUSION: While Mohs micrographic surgery may be considered the gold standard, wide local excision and adjuvant radiotherapy offers comparable control rates. Doses of 50 Gy or greater should be prescribed with generous margins (3-5 cm) owing to its tendency for peri-neural and deep invasion. There was no evidence that radiotherapy can cause aggressive transformation of the tumour. The role for definitive radiotherapy remains uncertain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".