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Multimodality Treatment of Merkel Cell Carcinoma: Case Series and Literature Review of 1024 Cases

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Abstract

Background: Merkel cell carcinoma (MCC) is an unusual and potentially aggressive cancer of the skin. There is no consensus regarding the optimal therapeutic approach, and the relative roles of surgery, radiotherapy, and chemotherapy still are controversial The aim of this study is to analyze the roles of these therapeutic options.

Methods: The medical records of 16 patients with a diagnosis of localized, primary MCC treated at the University of Alabama at Birmingham were reviewed. An extensive review of the English-language literature also was performed. The Kaplan-Meier method was used to develop the survival curves. Comparisons were made using Fisher’s exact test. Significance was defined as P < .05.

Results: MCC presented primarily in Caucasians (98.3%) with a median age of 69 years. Immunosuppressive therapy appeared to play a role in the development of this cancer. In the UAB experience, 3-year actuarial survival was 31%. The only factor significantly associated with overall survival was the stage of disease at presentation: median survivals were 97 vs. 15 months for stages I and II, respectively (log-rank, P = .02). From the literature review, adjuvant radiotherapy was associated with a reduced risk of local recurrence (P < .00001).

Conclusions: MCC is an aggressive cancer, with a high tendency for local recurrence and distant spread. Surgery and adjuvant radiotherapy appear to provide optimal local control. The role of chemotherapy remains to be defined.

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Authors and Affiliations

  1. Department of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama

    Heriberto Medina-Franco MD, Marshall M. Urist MD, Martin J. Heslin MD, Kirby I. Bland MD & Samuel W. Beenken MD

  2. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama

    John Fiveash MD

  3. University of Alabama at Birmingham, 321 Kracke Building, 1922 Seventh Avenue South, Birmingham, AL, 35233

    Samuel W. Beenken MD

Authors
  1. Heriberto Medina-Franco MD
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  2. Marshall M. Urist MD
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  3. John Fiveash MD
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  4. Martin J. Heslin MD
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  5. Kirby I. Bland MD
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  6. Samuel W. Beenken MD
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Medina-Franco, H., Urist, M.M., Fiveash, J. et al. Multimodality Treatment of Merkel Cell Carcinoma: Case Series and Literature Review of 1024 Cases. Ann Surg Oncol 8, 204–208 (2001). https://doi.org/10.1007/s10434-001-0204-4

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  • DOI: https://doi.org/10.1007/s10434-001-0204-4

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