BACKGROUND: Although sentinel lymph node biopsy (SNB) has become a standard for Merkel cell carcinoma (MCC), the impact on survival is unclear. To better define the staging and therapeutic value of SNB, we compared SNB with nodal observation. METHODS: Patients with clinical stage I and II MCC in the Surveillance, Epidemiology, and End Results (SEER) registry undergoing surgery between 2003 and 2009 were identified and divided into two groups-SNB and observation. RESULTS: A total of 1,193 patients met the inclusion criteria (SNB 474 and Observation 719). The median age was 78 years, and the majority were White (95.3 %), male (58.8 %), received radiation therapy (52.9 %) and had T1 tumors (65.3 %). Twenty-four percent had a positive SNB. SNB patients were younger (73 vs. 81 years; p < 0.0001), had T1 tumors (69.6 vs. 62.5 %; p = 0.04) and received radiotherapy (57.8 vs. 40 %; p < 0.0001). Among biopsy patients, a negative SNB was associated with improved 5-year MCC-specific survival (84.5 vs. 64.6 %; p < 0.0001). Univariate analysis demonstrated an increased 5-year MCC-specific survival for the SNB group versus the Observation group (79.2 vs. 73.8 %; p = 0.004), female gender (83.2 vs. 70.4 %; p = 0.0004), and lower T stage (p < 0.0001). On Cox regression, diminished survival was noted for the Observation group (risk ratio [RR] 1.43; p = 0.04), male gender (RR 2.06; p < 0.0001), and a higher T stage. CONCLUSION: SNB for MCC provides prognostic information and is associated with a significant survival advantage.
BACKGROUND: Although sentinel lymph node biopsy (SNB) has become a standard for Merkel cell carcinoma (MCC), the impact on survival is unclear. To better define the staging and therapeutic value of SNB, we compared SNB with nodal observation. METHODS:Patients with clinical stage I and II MCC in the Surveillance, Epidemiology, and End Results (SEER) registry undergoing surgery between 2003 and 2009 were identified and divided into two groups-SNB and observation. RESULTS: A total of 1,193 patients met the inclusion criteria (SNB 474 and Observation 719). The median age was 78 years, and the majority were White (95.3 %), male (58.8 %), received radiation therapy (52.9 %) and had T1 tumors (65.3 %). Twenty-four percent had a positive SNB. SNB patients were younger (73 vs. 81 years; p < 0.0001), had T1 tumors (69.6 vs. 62.5 %; p = 0.04) and received radiotherapy (57.8 vs. 40 %; p < 0.0001). Among biopsy patients, a negative SNB was associated with improved 5-year MCC-specific survival (84.5 vs. 64.6 %; p < 0.0001). Univariate analysis demonstrated an increased 5-year MCC-specific survival for the SNB group versus the Observation group (79.2 vs. 73.8 %; p = 0.004), female gender (83.2 vs. 70.4 %; p = 0.0004), and lower T stage (p < 0.0001). On Cox regression, diminished survival was noted for the Observation group (risk ratio [RR] 1.43; p = 0.04), male gender (RR 2.06; p < 0.0001), and a higher T stage. CONCLUSION: SNB for MCC provides prognostic information and is associated with a significant survival advantage.
Authors: Neal Bhatia; Andrew Blauvelt; Marc Brown; Whitney High; Craig T Leonardi; Ted Rosen; Linda Stein Gold; Eggert Stockfleth; Bruce Strober; Neil A Swanson; George Martin Journal: J Clin Aesthet Dermatol Date: 2014-07
Authors: Adrienne B Shannon; Richard J Straker; Michael J Carr; James Sun; Karenia Landa; Kirsten Baecher; Kevin Lynch; Harrison G Bartels; Robyn Panchaud; Luke J Keele; Michael C Lowe; Craig L Slingluff; Mark J Jameson; Kenneth Y Tsai; Mark B Faries; Georgia M Beasley; Vernon K Sondak; Giorgos C Karakousis; Jonathan S Zager; John T Miura Journal: Ann Surg Oncol Date: 2022-07-22 Impact factor: 4.339
Authors: Christopher K Bichakjian; Thomas Olencki; Sumaira Z Aasi; Murad Alam; James S Andersen; Rachel Blitzblau; Glen M Bowen; Carlo M Contreras; Gregory A Daniels; Roy Decker; Jeffrey M Farma; Kris Fisher; Brian Gastman; Karthik Ghosh; Roy C Grekin; Kenneth Grossman; Alan L Ho; Karl D Lewis; Manisha Loss; Daniel D Lydiatt; Jane Messina; Kishwer S Nehal; Paul Nghiem; Igor Puzanov; Chrysalyne D Schmults; Ashok R Shaha; Valencia Thomas; Yaohui G Xu; John A Zic; Karin G Hoffmann; Anita M Engh Journal: J Natl Compr Canc Netw Date: 2018-06 Impact factor: 12.693
Authors: Seesha R Takagishi; Tessa E Marx; Christopher Lewis; Erica S Tarabadkar; Ilsa D Juhlin; Astrid Blom; Jayasri G Iyer; Jay J Liao; Yolanda D Tseng; Teresa Fu; Paul Nghiem; Upendra Parvathaneni Journal: Adv Radiat Oncol Date: 2016-10-20
Authors: Kelly L Harms; Mark A Healy; Paul Nghiem; Arthur J Sober; Timothy M Johnson; Christopher K Bichakjian; Sandra L Wong Journal: Ann Surg Oncol Date: 2016-05-19 Impact factor: 5.344