Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma - 14/03/14
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Abstract |
Background |
The effects of primary tumor size on nodal involvement and of number of involved nodes on survival have not, to our knowledge, been examined in a national database of Merkel cell carcinoma (MCC).
Objective |
We sought to analyze a retrospective cohort of patients with MCC from the largest US national database to assess the relationships between these clinical parameters and survival.
Methods |
A total of 8044 MCC cases in the National Cancer Data Base were analyzed.
Results |
There was a 14% risk of regional nodal involvement for 0.5-cm tumors that increased to 25% for 1.7-cm (median-sized) tumors and to more than 36% for tumors 6 cm or larger. The number of involved nodes was strongly predictive of survival (0 nodes, 76% 5-year relative survival; 1 node, 50%; 2 nodes, 47%; 3-5 nodes, 42%; and ≥6 nodes, 24%; P < .0001 for trend). Younger and/or male patients were more likely to undergo pathological nodal evaluation.
Limitations |
The National Cancer Data Base does not capture disease-specific survival. Hence, relative survival was calculated by comparing overall survival with age- and sex-matched US population data.
Conclusion |
Pathologic nodal evaluation should be considered even for patients with small primary MCC tumors. The number of involved nodes is strongly predictive of survival and may help improve prognostic accuracy and management.
Le texte complet de cet article est disponible en PDF.Key words : average tumor size, Merkel cell carcinoma, National Cancer Data Base, neuroendocrine carcinoma of the skin, nodal spread, prognosis, regional node metastasis, sentinel lymph node biopsy
Abbreviations used : CI, HR, MCC, NCDB
Plan
Supported by National Institutes of Health (NIH) K02-AR50993, American Cancer Society RSG-08-115-01-CCE, NIH K24-CA139052, the David and Rosalind Bloom Endowment for Merkel Cell Carcinoma Research, the Michael Piepkorn Endowment, and the University of Washington Merkel Cell Carcinoma Patient Gift Fund. |
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Conflicts of interest: None declared. |
Vol 70 - N° 4
P. 637-643 - avril 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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