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Lymph Node Procedures of the Trunk and Extremities

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Merkel Cell Carcinoma

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Abstract

For most solid tumors, lymph node status is an important prognostic factor which suggests that the cancer is no longer localized and has the potential for systemic micrometastatic spread. In patients with Merkel cell carcinoma, regional lymphatic metastasis portends a poor prognosis. Analysis of 1,034 patients within the Surveillance, Epidemiology and End Results Program demonstrated a 5-year relative survival rate of 59 % in patients with nodal metastases as compared to 75 % in patients with node negative Merkel cell carcinoma (J Am Acad Dermatol 49:832–841, 2003).

Development of techniques to identify patients with microscopic, subclinical metastatic disease to the regional lymph nodes for both prognostic and therapeutic purposes lead to the development of lymphatic mapping and sentinel lymph node biopsy (SLNB). For patients who are able to tolerate the anesthesia required for SLNB, the benefits of accurate prognostic information seem to outweigh the risks of the procedure. Complete regional lymph node dissections as can be undertaken either for palliative purposes in patients with bulky metastatic nodal disease or in an attempt to improve survival in patients with micrometastatic disease. Prospective randomized studies evaluating the effect of therapeutic interventions on regional lymph nodes must be undertaken to determine whether patients are deriving a benefit.

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Authors and Affiliations

  1. Department of Surgery, University Hospitals Case Medical Center, LKSD 5047, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Julian Kim

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  1. Julian Kim
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Correspondence to Julian Kim .

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Editors and Affiliations

  1. Department of Dermatology, Northwestern University, Chicago, 60611, Illinois, USA

    Murad Alam

  2. University Hospitals Case Medical Center, Department of Dermatology, Case Western Reserve University, Cleveland, 44106, Ohio, USA

    Jeremy S. Bordeaux

  3. Department of Dermatology, University of California, San Francisco, San Francisco, 94115, California, USA

    Siegrid S. Yu

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Kim, J. (2013). Lymph Node Procedures of the Trunk and Extremities. In: Alam, M., Bordeaux, J., Yu, S. (eds) Merkel Cell Carcinoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6608-6_8

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  • DOI: https://doi.org/10.1007/978-1-4614-6608-6_8

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6607-9

  • Online ISBN: 978-1-4614-6608-6

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