Sentinel lymph node biopsy in Merkel cell carcinoma: Predictors of sentinel lymph node positivity and association with overall survival - 27/07/19
Abstract |
Background |
Merkel cell carcinoma (MCC) is a rare, aggressive malignancy with high rates of recurrence and metastasis.
Objective |
To evaluate predictors of sentinel lymph node (SLN) positivity in MCC using the National Cancer Database.
Methods |
The National Cancer Database, from 2012 to 2014, was used to identify 3048 patients with MCC, of whom 1174 received an SLN biopsy. Predictors of SLN positivity were evaluated using logistic regression. Overall survival was evaluated using a Cox proportional hazards model.
Results |
Of patients who underwent SLN biopsy, those with primary lesions on the trunk (odds ratio, 1.98; 95% confidence interval [CI], 1.23-3.17; P = .004), tumor-infiltrating lymphocytes (odds ratio, 1.58; 95% CI, 1.01-2.46; P = .04), or lymphovascular invasion (odds ratio, 3.45; 95% CI, 2.51-4.76; P < .001) were more likely to have positive SLNs on multivariate analysis. Overall survival was negatively affected by age ≥75 years (hazard ratio [HR], 2.55; 95% CI, 1.36-4.77; P = .003), male sex (HR, 1.78; 95% CI, 1.09-2.91, P = .022), immunosuppression (HR, 3.51; 95% CI, 1.72-7.13; P = .001), and SLN positivity (HR, 3.15; 95% CI, 1.98-5.04; P < .001).
Limitations |
Lack of disease-specific survival and potential selection bias from a retrospective data set.
Conclusions |
Truncal MCC, tumor-infiltrating lymphocytes, and presence of lymphovascular invasion were independent predictors of positive SLNs. Overall survival was negatively affected by advancing age, male sex, immunosuppression, and SLN positivity.
Le texte complet de cet article est disponible en PDF.Key words : lymphovascular invasion, Merkel cell carcinoma, National Cancer Database, overall survival, sentinel lymph node biopsy, tumor-infiltrating lymphocytes
Abbreviations used : CI, HR, LVI, MCC, NCDB, OR, OS, SLN, SLNB, TIL
Plan
| Funding sources: None. |
|
| Conflicts of interest: None disclosed. |
|
| Reprints not available from the authors. |
Vol 81 - N° 2
P. 364-372 - août 2019 Retour au numéro
Article précédent
- Nonbullous pemphigoid: Insights in clinical and diagnostic findings, treatment responses, and prognosis
- Aniek Lamberts, Joost M. Meijer, Hendri H. Pas, Gilles F.H. Diercks, Barbara Horváth, Marcel F. Jonkman
- Risk factors for keratinocyte carcinoma skin cancer in nonwhite individuals: A retrospective analysis
- Kumar S. Nadhan, Christina L. Chung, Erin M. Buchanan, Christine Shaver, Scott Shipman, Rina M. Allawh, Melissa L. Hoffman, Geoffrey Lim, Mark Abdelmalek, Carrie Ann Cusack
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?