Does chemotherapy improve survival in high-risk stage I and II Merkel cell carcinoma of the skin?

Poulsen, Michael; Rischin, Danny; Porter, Ian; Walpole, Euan; Harvey, Jennifer A.; Hamilton, C.S.; Keller, Jacqui; Tripcony, Lee

doi:10.1016/j.ijrobp.2005.04.042

Cited by 162 publications

(104 citation statements)

References 19 publications

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“…A phase 2 study of concurrent and adjuvant cisplatin and etoposide in high-risk MCC patients initially reported favorable outcomes 48 ; however, an update with further analyses demonstrated no significant improvement in OS or DSS when compared with historical controls. 49 Given the known chemotherapyrelated morbidity and mortality in conjunction with no clear evidence of improved outcomes, adjuvant chemotherapy is currently not routinely recommended. 50 Original Article…”

Section: Discussionmentioning

confidence: 99%

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Fang

Lemos

Douglas

et al. 2010

Cancer

145

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BACKGROUND:Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high risk of lymph node involvement. To the authors' knowledge, few data have been published to date regarding the optimal regional therapy for lymph node‐positive patients. This cohort study was performed to analyze the outcomes of patients with lymph node‐positive MCC treated with lymph node irradiation as definitive therapy compared with completion lymphadenectomy (CLND).METHODS:Fifty patients with lymph node involvement of MCC at presentation and adequate follow‐up data were included in this analysis. Forty‐three of these patients were enrolled and followed prospectively. Twenty‐six patients presented with microscopic lymph node disease, and 24 patients presented with palpable lymph node involvement.RESULTS:Regional control for patients with microscopically involved lymph nodes was 100% regardless of treatment modality—definitive lymph node irradiation (n = 19) or CLND ± radiotherapy (n = 7) with median follow‐up of 18 months. Patients with clinically positive lymph nodes had 2‐year regional recurrence‐free survival rate of 78% and 73% in the definitive lymph node irradiation (n = 9) and CLND ± radiotherapy (n = 15) groups, respectively (P = .8) with a median follow‐up of 16 months.CONCLUSIONS:To the best of the authors' knowledge, the current study is the largest series published to date of radiation monotherapy as regional treatment for lymph node‐positive MCC. Lymph node irradiation alone to positive regional lymph nodes was found to confer an excellent regional control rate that was comparable to CLND for both microscopic and palpable lymph node disease. There was no difference noted with regard to overall survival. Given their similar efficacy, the choice between these lymph node therapies may be based on the clinical scenario and anticipated side effect profiles. Cancer 2010. © 2010 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Fang

Lemos

Douglas

et al. 2010

Cancer

145

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“…Owing to the rareness of the disease, very little data are available on the efficacy of chemotherapy and the results are conflicting. 4,5 Overall 5-year survival ranges from 31 to 74%. 6 Targeted anticancer therapies have been found to be very promising options in the treatment of different forms of cancer such as renal cell carcinoma 7,8 and gastrointestinal stromal tumors.…”

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confidence: 99%

Expression of VEGF-A/C, VEGF-R2, PDGF-α/Β, c-kit, EGFR, Her-2/Neu, Mcl-1 and Bmi-1 in Merkel cell carcinoma

et al. 2008

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“…Por cierto, existe una alta incidencia de efectos adversos de ésta reportados en la literatura 12 . Algunos análisis multivariados sugieren que la quimioterapia no tendría efecto en la sobrevida, siendo necesarios estudios randomizados con poblaciones de mayor número para lograr confirmar verdaderamente el rol de la quimioterapia en pacientes con CCM de alto riesgo 13 . Se estima que la cirugía más irradiación local adyuvante estaría asociada a niveles más bajos de recurrencia, tanto local como regional, en comparación con sólo cirugía para CCM, aunque lógicamente se necesita de investigaciones prospectivas para clarificar el beneficio de la terapia combinada…”

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Carcinoma de células de Merkel en la región perianal: Reporte de un caso

et al. 2009

Rev Chil Cir

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Merkel cell carcinoma. Report of one caseMerkel cell carcinoma is a rare neuroendocrine tumor typically found on sun-exposed areas such as face and extremities. We report a 57 years old male presenting with a tumor in the left perianal region that prior to surgery was catalogued as a perianal teratoma. The pathological study informed a Merkel cell tumor. It was locally excised and a cutaneous flap was made. Two years after surgery, the patient had pulmonary metastases and chemotherapy was started. Due to lack of response, it was discontinued after four cycles.Key words: Merkel cell tumor, local excision, pulmonary metastases. ResumenLos tumores de células de Merkel, son raros tumores neuroendocrinos que típicamente son encontrados en zonas expuestas al sol como cara y extremidades. Describimos un caso de un paciente de 57 años de edad con una tumoración en la región perianal que inicialmente se catalogó como un teratoma, cuya histopatología informó un tumor de células de Merkel. Se manejo con resección local amplia y colgajo cutáneo. Después de 2 años de la cirugía, el paciente evolucionó con claros signos de enfermedad metastásica pulmonar y actualmente se encuentra en manejo paliativo con quimioterapia.Palabras clave: Tumor de células de Merkel, resección local, enfermedad metastásica. IntroducciónEl carcinoma de células de Merkel o carcinoma neuroendocrino cutáneo es un tumor poco frecuente y agresivo, asociado a una elevada tendencia a invasión ganglionar, recurrencia y metástasis a distancia. La etiología de éste, así como en muchos de los tumores cutáneos descritos, es desconocida. La hipótesis más aceptada es aquella que describe el efecto oncogénico de las radiaciones solares aso- CASOS CLÍNICOS

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Does chemotherapy improve survival in high-risk stage I and II Merkel cell carcinoma of the skin?

Cited by 162 publications

References 19 publications

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Expression of VEGF-A/C, VEGF-R2, PDGF-α/Β, c-kit, EGFR, Her-2/Neu, Mcl-1 and Bmi-1 in Merkel cell carcinoma

Carcinoma de células de Merkel en la región perianal: Reporte de un caso

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