Annals of Surgical Oncology

, 16:2985

Single-Institution Series of Early-Stage Merkel Cell Carcinoma: Long-Term Outcomes in 95 Patients Managed with Surgery Alone

  • Emilio Bajetta
  • Luigi Celio
  • Marco Platania
  • Salvatore Lo Vullo
  • Roberto Patuzzo
  • Andrea Maurichi
  • Mario Santinami
Melanomas

DOI: 10.1245/s10434-009-0615-1

Cite this article as:
Bajetta, E., Celio, L., Platania, M. et al. Ann Surg Oncol (2009) 16: 2985. doi:10.1245/s10434-009-0615-1

Abstract

Aim

To determine the long-term outcomes of early-stage Merkel cell carcinoma (MCC) patients managed with surgery alone.

Methods

Ninety-five consecutive patients were reviewed. Patients were treated by wide local excision. Clinically negative regional nodes were either followed up (n = 42) or staged with sentinel lymph node biopsy (n = 21), and clinically positive nodes underwent lymph node dissection (n = 32).

Results

Median follow-up was 65 months. A total of 45 (47%) patients relapsed, with 80% of the recurrences occurring within 2 years and 96% within 5 years. The 5-year crude cumulative incidence (CCI) of recurrence and disease-specific survival (DSS) were 52% and 67%, respectively. CCI of local 5-year recurrence was 5% for the study cohort. Patients with MCC in the head and neck region had a 5-year local-recurrence CCI of 19%, and patients with MCC in the extremity and trunk region had a 5-year local-recurrence CCI of 2% (P = 0.007). Comparing patients with ≤ 2 versus > 2 metastatic lymph nodes, the 5-year regional-recurrence CCI was 0% versus 39% (P = 0.004). The 5-year distant-recurrence CCI was higher in clinically node-positive patients compared with node-negative patients (37% versus 12%; P = 0.005). Patients with MCC in the head and neck region experienced no distant recurrences, patients with MCC in the extremity and trunk region had a 5-year distant-recurrence CCI of 22%, and patients with occult primary had a 5-year distant-recurrence CCI of 49% (P = 0.023). The 5-year DSS rate was 80% for pathologically node-negative patients.

Conclusion

The prognosis for surgically managed early-stage MCC is variable. Thus multidisciplinary tumor-board consultation is needed to optimize individual patient management.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Emilio Bajetta
    • 1
  • Luigi Celio
    • 1
  • Marco Platania
    • 1
  • Salvatore Lo Vullo
    • 2
  • Roberto Patuzzo
    • 3
  • Andrea Maurichi
    • 3
  • Mario Santinami
    • 3
  1. 1.Department of MedicineFondazione IRCCS “Istituto Nazionale Tumori”MilanItaly
  2. 2.Unit of Medical Statistics and BiometryFondazione IRCCS “Istituto Nazionale Tumori”MilanItaly
  3. 3.Department of SurgeryFondazione IRCCS “Istituto Nazionale Tumori”MilanItaly