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Management of Merkel Cell Carcinoma: The Roles of Lymphoscintigraphy, Sentinel Lymph Node Biopsy and Adjuvant Radiotherapy

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Merkel cell carcinoma (MCC) is an uncommon, highly aggressive skin malignancy with a propensity to recur locally and regionally. However, its optimal treatment is uncertain. In this study, we aimed to assess the roles of lymphoscintigraphy and sentinel node (SN) biopsy, as well as radiotherapy, in the treatment of MCC.

Patients and Methods

A retrospective analysis of 17 patients diagnosed with MCC (median age 74 years) over a 7-year period (median follow-up 16 months) was performed.

Results

Of 11 patients. 3 had a positive SN biopsy and, despite adjuvant radiotherapy, 2 of these 3 developed regional lymph node (RLN) recurrence. Of the remaining 8 patients who had a negative SN biopsy, however, 5 also had RLN recurrences. There were 9 patients who received adjuvant radiotherapy (RT) to the primary site, with no in-field recurrences; and 8 who received RT to their RLN field, with only 2 developing regional nodal recurrences—both were SN biopsy positive. During the follow-up period, 2 patients died, only 1 due to MCC.

Conclusion

The results suggest that SN status may not be an accurate predictor of loco-regional recurrence in MCC. However, they strongly reinforce previous reports that radiotherapy, both locally and to regional nodes, provides effective infield disease control.

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Authors and Affiliations

  1. Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia

    Ross E. Warner MBBS, Michael J. Quinn MBBS, Richard A. Scolyer MD & John F. Thompson MD

  2. Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia

    George Hruby MBCLB

  3. Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia

    Richard A. Scolyer MD

  4. Discipline of Pathology, The University of Sydney, Sydney, NSW, 2006, Australia

    Richard A. Scolyer MD

  5. Nuclear Medicine and Diagnostic Ultrasound, Royal Prince Alfred Hospital Medical Centre, Newtown, NSW, 2042, Australia

    Roger F. Uren MD

  6. Discipline of Medicine, The University of Sydney, Sydney, NSW, 2006, Australia

    Roger F. Uren MD

  7. Discipline of Surgery, The University of Sydney, Sydney, NSW, 2006, Australia

    John F. Thompson MD

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  1. Ross E. Warner MBBS
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  2. Michael J. Quinn MBBS
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  4. Richard A. Scolyer MD
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Correspondence to John F. Thompson MD.

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Warner, R.E., Quinn, M.J., Hruby, G. et al. Management of Merkel Cell Carcinoma: The Roles of Lymphoscintigraphy, Sentinel Lymph Node Biopsy and Adjuvant Radiotherapy. Ann Surg Oncol 15, 2509–2518 (2008). https://doi.org/10.1245/s10434-008-9983-1

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  • DOI: https://doi.org/10.1245/s10434-008-9983-1

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