International Journal of Clinical Oncology

, Volume 20, Issue 1, pp 188–193

Role of sentinel lymph node biopsy in patients with Merkel cell carcinoma: statistical analysis of 403 reported cases

  • Yoshitsugu Shibayama
  • Shinichi Imafuku
  • Akira Takahashi
  • Juichiro Nakayama
Original Article

Abstract

Background

Merkel cell carcinoma (MCC) is a rare cutaneous malignancy with a high rate of nodal metastasis. Sentinel lymph node biopsy (SLNB) is used in MCC and other cancers to identify regional node micrometastases in patients with clinically negative nodes; however, whether SLN status is associated with recurrence or prognosis in MCC is unclear.

Methods

A statistical analysis was performed of 397 published cases of MCC with SLNB results from 22 reports and 6 new cases, in order to elucidate any correlation between SLN status and recurrence, and to determine false-negative rates for SLNB.

Results

Of these 403 cases, 128 (31.8 %) had positive SLNs; 16 of these 128 (12.5 %) developed recurrence (6 nodal, 10 distant). Of 275 patients with negative SLNs, 27 (9.8 %) developed recurrence (19 nodal, 8 distant). Patients with positive SLNs had a greater risk of distant metastasis (OR 2.82; P = 0.037; 95 % CI 1.089–7.347). The false-negative rate for SLNB in all 403 patients was 12.9 %. Use of the immunohistochemical approach to diagnosis of micrometastasis with anti-CK20 antibody did not affect the false-negative rate.

Conclusions

Patients with positive SLNs had a greater risk of distant metastasis in MCC; positive SLN was an important prognostic factor in MCC. Further studies using standardized, more-sensitive techniques to examine entire SLNs may decrease the false-negative rate, and improve the significance of SLNB in MCC.

Keywords

Merkel cell carcinoma Sentinel lymph node False negative Recurrence Meta-analysis 

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Copyright information

© Japan Society of Clinical Oncology 2014

Authors and Affiliations

  • Yoshitsugu Shibayama
    • 1
  • Shinichi Imafuku
    • 1
  • Akira Takahashi
    • 1
  • Juichiro Nakayama
    • 1
  1. 1.Department of Dermatology, Faculty of MedicineFukuoka UniversityFukuokaJapan

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