Surgical management of Merkel cell carcinoma Journal Article
| Authors: | Allen, P. J.; Zhang, Z. F.; Coit, D. G. |
| Article Title: | Surgical management of Merkel cell carcinoma |
| Abstract: | Objectives: To characterize the natural history of Merkel cell carcinoma (MCC) and to analyze the influence of patient, tumor, and treatment-related variables on survival and recurrence. Summary Background Data: Approximately 425 cases of MCC have been described in the literature. This study represents the largest experience reported. Methods: A review was performed of patients who had been treated at Memorial Sloan-Kettering Cancer Center for MCC between 1969 and 1996. Follow-up data were available for 102 of the 109 (94%) patients identified. Results: The overall 5-year disease-specific survival rate was 74%. The median follow-up was 35 months. For all patients, the only independent predictor of survival was the tumor stage at presentation. For patients with stage I disease, the tumor size at presentation was also an independent predictor of survival. Recurrence of disease occurred in 55 patients (55%), and the most common site of first recurrence was within the draining lymph nodes (n = 35). Elective lymph node dissection was the only parameter independently predictive of improved relapse-free survival. The overall disease-specific survival rate after recurrence was 62%. Predictors of improved disease-specific survival after recurrence included nodal as compared to local or distant recurrence, the ability to render the patient free of disease after recurrence, and a disease-free interval of >8 months. Conclusion: The prognosis for patients with MCC is favorable, and even after recurrence the majority of patients experience long-term survival. Incorporation of size into the staging system more accurately predicts survival in patients with stage I disease. Although elective lymph node dissection decreased the rate of recurrence, it was not associated with improved overall survival. |
| Keywords: | adult; cancer survival; aged; aged, 80 and over; disease-free survival; middle aged; survival rate; major clinical study; cancer recurrence; doxorubicin; cancer staging; lymph node dissection; carboplatin; neoplasm recurrence, local; skin neoplasms; tumor volume; etoposide; cyclophosphamide; vincristine; neoplasm metastasis; merkel cell tumor; carcinoma, merkel cell; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Annals of Surgery |
| Volume: | 229 |
| Issue: | 1 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1999-01-01 |
| Start Page: | 97 |
| End Page: | 105 |
| Language: | English |
| DOI: | 10.1097/00000658-199901000-00013 |
| PUBMED: | 9923806 |
| PROVIDER: | scopus |
| PMCID: | PMC1191614 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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