Merkel cell carcinoma: Prognosis and treatment of patients from a single institution Journal Article
| Authors: | Allen, P. J.; Bowne, W. B.; Jaques, D. P.; Brennan, M. F.; Busam, K.; Coit, D. G. |
| Article Title: | Merkel cell carcinoma: Prognosis and treatment of patients from a single institution |
| Abstract: | Purpose: Merkel cell carcinoma (MCC) is an uncommon cutaneous malignancy. Most reports consist of single-institution experiences of fewer than 30 patients. The natural history of MCC is poorly defined. Patients and Methods: A review was performed of Memorial Sloan-Kettering Cancer Center's MCC database, identifying 251 patients who had been treated between 1970 and 2002. Patient, tumor, and treatment-related factors were analyzed for their association with recurrence and survival. Results: The average follow-up for all patients was 40 months and 46 months for patients alive at last follow-up. The 5-year disease-specific survival rate was 64%. Disease stage was the only independent predictor of survival (stage I, 81 %; stage II, 67%; stage III, 52%; stage IV, 11 %; P = .001). Pathologic staging of the draining nodal basin was performed in 71 (40%) of 177 patients who presented with clinically negative nodes, and 16 of these patients (23%) were found to have node-positive disease. Pathologic nodal staging was associated with improved stage-specific survival probabilities (clinical node-negative, 75% v pathologic node-negative disease, 97%; P = .009) and decreased nodal recurrence (44% v 11%, P < .001). The median time to recurrence was 9 months, and 102 patients (43%) recurred. Local recurrence developed in 8% of patients after margin-negative excision. Conclusion: These data demonstrate that the natural history of MCC is variable and dependent on the stage of disease at presentation. Pathologic nodal staging identifies a group of patients with excellent long-term survival. After margin-negative excision and pathologic nodal staging, local and nodal recurrence rates are low. © 2005 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; retrospective studies; major clinical study; disease free survival; cancer staging; follow up; lymph node metastasis; lymphatic metastasis; lymphadenectomy; carboplatin; neoplasm recurrence, local; skin neoplasms; etoposide; pathology; retrospective study; skin tumor; tumor recurrence; merkel cell tumor; carcinoma, merkel cell; factual database; databases, factual; merkel cell |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 23 |
| Issue: | 10 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2005-01-01 |
| Start Page: | 2300 |
| End Page: | 2309 |
| Language: | English |
| DOI: | 10.1200/jco.2005.02.329 |
| PUBMED: | 15800320 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 235" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus" |
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