{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:46:04Z","timestamp":1778111164477,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Aggressive digital papillary adenocarcinoma (ADPA) is a rare skin adnexal tumor with a predilection for the hand. The presentation, treatment, and outcomes of ADPA remain poorly defined due to the scarcity of reports and low-level evidence of published findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a meta-analysis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines with the intent to provide hand surgeons a better understanding of the diagnosis and treatment of the disease. Three additional cases of ADPA from our institution were combined with the results from the systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 238 cases were included in the meta-analysis. Most ADPAs were painful, evolving, and less than 2 cm in size. Regional sentinel lymph node biopsies were performed in 55 patients, of which 25.5% were positive. Overall cohort recurrence and distant metastasis rates were 24.3% and 18.1%, respectively. Patients who obtained clear margins within 6 months of diagnosis had significantly lower rates of recurrence, metastasis, and mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003, respectively). There were no differences in recurrence or metastasis rates in those who obtained clear margins by excision or amputation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .27 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .07, respectively). In patients who died from disease (6.0%), 5.0 years was the average time to death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Aggressive digital papillary adenocarcinoma should be included in the differential diagnosis of hand lesions with unusual presentations or lack of response to other therapies. Clear margins should be obtained within 6 months of diagnosis, and routine surveillance should be provided by an oncologic physician familiar with ADPA as these tumors have high recurrence rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241308612","type":"journal-article","created":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T01:35:22Z","timestamp":1736559322000},"page":"462-471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Aggressive Digital Papillary Adenocarcinoma: A Meta-Analysis of the Presentation, Treatment, and Outcomes of a Rare Hand Tumor"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2731-5526","authenticated-orcid":false,"given":"Shaun D.","family":"Mendenhall","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily M.","family":"Graham","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha N.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Mercy Clinic Orthopedics, Ozark, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan W.","family":"Schmucker","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, the Ohio State University Wexner Medical Center, Columbus, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob P.","family":"Veith","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-8201","authenticated-orcid":false,"given":"Jennifer L.","family":"Koechle","sequence":"additional","affiliation":[{"name":"Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Neumeister","sequence":"additional","affiliation":[{"name":"Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2016147"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/2309499021993994"},{"key":"e_1_3_2_4_2","volume-title":"Am Acad Dermatol Clin Pathol Conf","author":"Helwig EB","year":"1979","unstructured":"Helwig EB. Aggressive digital papillary adenoma. Unpublished data. Am Acad Dermatol Clin Pathol Conf; Chicago, 1979."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200006000-00002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1987.tb00488.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.04137.x"},{"issue":"2","key":"e_1_3_2_8_2","first-page":"145","article-title":"Metastatic aggressive digital papillary adenocarcinoma","volume":"72","author":"Altman CE","year":"2003","unstructured":"Altman CE, Hamill RL, Elston DM. Metastatic aggressive digital papillary adenocarcinoma. 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