The Essential Role of Radiotherapy in the Treatment of Merkel Cell Carcinoma: A Study From the Rare Cancer Network

Ghadjar, Pirus; Kaanders, J.H.A.M.; Poortmans, P.; Zaucha, Renata; Krengli, Marco; Lagrange, Jean‐Léon; Özsoy, Orhan; Nguyễn, Thị Hiền; Miralbell, Raymond; Baize, A.; Boujelbene, N.; Collen, T.; Scandolaro, Luciano; Untereiner, M.; Goldberg, Hadassah; Pesce, Gianfranco G.A.; Anacak, Yavuz; Friedrich, Esther E.; Aebersold, Daniel M.; Beer, Karl K.T.

doi:10.1016/j.ijrobp.2011.05.028

Cited by 66 publications

(37 citation statements)

References 27 publications

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“…24 Our findings are nearly identical to those from a meta-analysis on 1254 MCC patients, 25 which reported a significantly lower rate of locoregional recurrence with adjuvant radiation therapy and improved (although not statistically significant) overall and disease-specific survival. A more recently published retrospective multicenter study 26 of 180 patients with MCC treated from 1988 through 2009 compared patients undergoing surgery alone with those who received surgery and postoperative radiation therapy and reported improved locoregional relapse-free survival and distant metastasis-free survival with radiation treatment but no difference in overall survival rates. In aggregate, our data support previously published studies that strongly suggest improved locoregional recurrence rates with adjuvant radiation treatment.…”

Section: Discussionmentioning

confidence: 99%

Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma

et al. 2014

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IMPORTANCE Merkel cell carcinoma (MCC) is a rare, aggressive, neuroendocrine-derived skin cancer with high rates of recurrence and associated mortality. Few published studies have used comprehensive patient data and long-term follow-up to examine factors that predict MCC outcomes. OBJECTIVE To characterize MCC in a large defined-population cohort and analyze predictors of disease recurrence and survival. SETTING, DESIGN, AND PARTICIPANTS Retrospective cohort study of 218 patients with MCC from the cancer registry of Kaiser Permanente Northern California, a large integrated health care delivery system. Patients were diagnosed as having MCC and followed up from January 1, 1995, through December 31, 2009. We examined host (age, sex, race, and immunosuppression), tumor (anatomic site, size, and extent), diagnostic (results of imaging and pathologic nodal evaluation), and treatment (surgery, radiation therapy, and chemotherapy) variables for their association with MCC outcomes. EXPOSURE Host, tumor, diagnostic, and treatment factors. MAIN OUTCOMES AND MEASURES Recurrence (locoregional and distant) of MCC and patient survival (overall and MCC specific). RESULTS We estimated adjusted hazard ratios (AHRs) and 95% CIs for outcomes using Cox proportional hazards regression models. After adjustment for host, tumor, diagnostic, and treatment variables, tumor extent (categorized as local, regional, and distant) remained significantly associated with all outcomes. Immunosuppression was associated with higher MCC-specific mortality (AHR, 4.9 [95% CI, 1.7–14.4]), and an unknown primary site was associated with a lower risk for distant metastasis (0.1 [0.0–0.7]) and improved survival (0.4 [0.2–0.9]). Pathological nodal evaluation was associated with a lower risk for metastasis (AHR, 0.2 [95% CI, 0.0–1.0]) and improved survival. Radiation treatment was associated with a decreased risk for locoregional recurrence (AHR, 0.3 [95% CI, 0.1–0.6]), whereas chemotherapy was not associated with any alteration in outcomes. CONCLUSIONS AND RELEVANCE Tumor site and extent, results of pathologic nodal evaluation, and the presence of radiation treatment were associated with MCC recurrence. Immunosuppression, tumor extent, and results of pathologic nodal evaluation were associated with MCC-specific survival, whereas chemotherapy was not associated with any outcomes. Our findings may help to inform diagnostic and therapeutic management of MCCs.

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Section: Discussionmentioning

confidence: 99%

Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma

et al. 2014

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“…The study also explains Ghadjar indications of radiotherapy, based primarily on locally advanced tumors as an improvement is achieved at the time of local recurrence vs. 93% 64% and distant disease 70% to 42%, but however not improve overall survival (56% vs. 46%; p=0.2) [29].…”

Section: Discussionmentioning

confidence: 74%

“…Five-year survival decreased progressively with increasing stage, from 60% to 80% for patients with stage I disease to 20% for those with stage IV disease. The difference in survival between stage I and II are significant, with 66% survival at 5 years versus 51% respectively [23,29].…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneal Merkel Cell Carcinoma without Skin Involvement: Literature Review and One Case Experience

Sota¹,

Vila²,

Giménez³

et al. 2017

Ann Clin Lab Res

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Merkel cell carcinoma (MCC) is an uncommon neuroendocrine tumor that represents a small percentage of skin malignancies, with an aggressive behavior and survival rate at 5 years of 20% to 80%. Among the risk factors, we find Ultraviolet radiation, polyomavirus, other malignancies and immunosuppression.Most of the MCC are diagnosed over 59 years old, being more frequent in men. According to the literature, only 2% to 5% had no skin involvement. Among regions involved, head and neck are the most frequent, followed by limbs and lymph nodes.We described a case of MCC without skin involvement, atypically located in retroperitoneum and given the rarity of both circumstances, we also conducted a review of the reported cases of retroperitoneal MCC without skin tumor.Among retroperitoneal MCC without primary skin involvement, we found 13 reported cases, the average age of these patients was 66 years old, being female only one case. They were all diagnosed by computerized tomography (CT) or Positron emission tomographycomputed tomography (PET-CT). The size of the main mass was variable (15 cm to 3 cm) and selected treatments were chemotherapy, surgery and radiation therapy. Survival rate is unknown in most of them.

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“…The most common regimen used for regional disease is cisplatin or carboplatin with or without etoposide [15]. Although combined treatment with radiotherapy and surgery has a better impact with significantly lower rates of local and regional recurrence of MCC than surgery alone [16], in the presented case, it was not possible to associate the treatments as required due to the history of paroxysmal tachycardia. Combination of carboplatin and etoposide followed by radiotherapy has shown, however, effective in inducing a reduction of the tumor mass with an acceptable toxicological profile.…”

Section: Discussionmentioning

confidence: 99%

Merkel Cell Carcinoma of the Retroperitoneum with No Identifiable Primary Site

Rossini

Caponnetto

Lapadula

et al. 2013

Case Reports in Oncological Medicine

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Merkel cell carcinoma (MCC) is an extremely rare primary neuroendocrine neoplasm of the skin that shows aggressive behavior and a poor prognosis. We report a case of a 67-year-old male with a Merkel cell carcinoma which initially presented itself as a large retroperitoneal mass. Pathological and immunohistochemical analysis revealed tissue consistent with neuroendocrine carcinoma. Despite complete medical workup, no other primary MCC could be detected. While being an atypical presentation, the tumor mass showed an excellent response to the combination of chemotherapy followed by radiotherapy.

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The Essential Role of Radiotherapy in the Treatment of Merkel Cell Carcinoma: A Study From the Rare Cancer Network

Cited by 66 publications

References 27 publications

Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma

Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma

Retroperitoneal Merkel Cell Carcinoma without Skin Involvement: Literature Review and One Case Experience

Merkel Cell Carcinoma of the Retroperitoneum with No Identifiable Primary Site

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