A Servy1, E Maubec2, P E Sugier3, F Grange4, S Mansard5, T Lesimple6, E Marinho7, B Couturaud8, A Girod8, S Albert9, R Dendale10, E Calitchi11, L Sarda12, J Chanal1, L Deschamps7, X Sastre-Garau13, L Laroche14, B Crickx15, M F Avril16. 1. Department of Dermatology, APHP, Hôpital Cochin, Paris. 2. University of Paris 13, Bobigny Department of Dermatology, APHP, Hôpital Avicenne, Bobigny UMR-946 INSERM, Genetic Variation and Human Diseases Unit (UMR-946), Paris eve.maubec@inserm.fr. 3. UMR-946 INSERM, Genetic Variation and Human Diseases Unit (UMR-946), Paris University of Pierre et Marie Curie, Paris University of Paris Diderot, Paris. 4. Department of Dermatology, Hôpital Robert-Debré, Reims. 5. Department of Dermatology, CHU Estaing, Clermont-Ferrand. 6. Department of Oncology, Centre Eugène-Marquis, Rennes. 7. Department of Pathology, APHP, Hôpital Bichat, Paris. 8. Department of Surgery, Institut Curie, Paris. 9. University of Paris Diderot, Paris Department of Otorhinolaryngology, APHP, Hôpital Bichat, Paris. 10. Department of Oncology, Institut Curie, Paris. 11. Department of Radiotherapy, Clinique de la Porte de Saint-Cloud, Boulogne. 12. University of Paris Diderot, Paris Department of Nuclear Medicine, APHP, Hôpital Lariboisière, Paris, Descartes. 13. Institut Curie, Department of Pathology, Paris. 14. University of Paris 13, Bobigny Department of Dermatology, APHP, Hôpital Avicenne, Bobigny. 15. University of Paris Diderot, Paris Department of Dermatology, APHP, Hôpital Bichat, Paris. 16. Department of Dermatology, APHP, Hôpital Cochin, Paris University of Paris Descartes, Paris, France.
Abstract
BACKGROUND: Sentinel lymph-node (LN) biopsy (SLNB) is a valuable tool to assess the regional LN status in Merkel cell carcinoma (MCC). However, its prognostic value is still debated. This study was undertaken to assess SLNB usefulness for MCC management and to determine the impact of SLNB status on disease-free survival (DFS) and overall survival (OS) by comparing SLNB-positive versus -negative patients according to demographic, clinical and treatment characteristics. PATIENTS AND METHODS: In this retrospective, multicenter observational study, SLNB was proposed to all patients referred for clinically N0 MCC. Treatment schedule consisted of wide-margin surgical resection of primary MCC followed by adjuvant radiation therapy (aRT) to the primary site and, for SLNB-positive patients, radical LN dissection followed by regional aRT. Univariate and multivariate analyses determined factors associated with DFS and OS. RESULTS: Among 87 patients with successful SLNB, 21 (24.1%) were SLNB-positive. Median follow-up for the entire series was 39 months; respective 3-year DFS and OS rates were 73% and 81.4%, respectively. Univariate analysis (all patients) identified SLNB-negativity as being associated with prolonged OS (P = 0.013) and aRT (all sites considered) was associated with longer DFS (P = 0.004) and OS (P = 0.018). Multivariate analysis (all patients) retained SLNB status and aRT (all sites considered) as being associated with improved DFS (P = 0.014 and 0.0008) and OS (P = 0.0020 and 0.0019). Moreover, for SLNB-negative patients, tumor-bed irradiation was also significantly associated with prolonged DFS (P = 0.006) and OS (P = 0.014). CONCLUSIONS: The present study demonstrates that SLNB-negativity is a strong predictor of longer DFS and OS in stage I and II MCC patients. The similar benefit for aRT on tumor bed observed in this study has to be confirmed by a prospective study. The results advocate for SLNB being considered to all MCC patients.
BACKGROUND: Sentinel lymph-node (LN) biopsy (SLNB) is a valuable tool to assess the regional LN status in Merkel cell carcinoma (MCC). However, its prognostic value is still debated. This study was undertaken to assess SLNB usefulness for MCC management and to determine the impact of SLNB status on disease-free survival (DFS) and overall survival (OS) by comparing SLNB-positive versus -negative patients according to demographic, clinical and treatment characteristics. PATIENTS AND METHODS: In this retrospective, multicenter observational study, SLNB was proposed to all patients referred for clinically N0 MCC. Treatment schedule consisted of wide-margin surgical resection of primary MCC followed by adjuvant radiation therapy (aRT) to the primary site and, for SLNB-positive patients, radical LN dissection followed by regional aRT. Univariate and multivariate analyses determined factors associated with DFS and OS. RESULTS: Among 87 patients with successful SLNB, 21 (24.1%) were SLNB-positive. Median follow-up for the entire series was 39 months; respective 3-year DFS and OS rates were 73% and 81.4%, respectively. Univariate analysis (all patients) identified SLNB-negativity as being associated with prolonged OS (P = 0.013) and aRT (all sites considered) was associated with longer DFS (P = 0.004) and OS (P = 0.018). Multivariate analysis (all patients) retained SLNB status and aRT (all sites considered) as being associated with improved DFS (P = 0.014 and 0.0008) and OS (P = 0.0020 and 0.0019). Moreover, for SLNB-negative patients, tumor-bed irradiation was also significantly associated with prolonged DFS (P = 0.006) and OS (P = 0.014). CONCLUSIONS: The present study demonstrates that SLNB-negativity is a strong predictor of longer DFS and OS in stage I and II MCC patients. The similar benefit for aRT on tumor bed observed in this study has to be confirmed by a prospective study. The results advocate for SLNB being considered to all MCC patients.
Authors: Jürgen C Becker; Andreas Stang; James A DeCaprio; Lorenzo Cerroni; Celeste Lebbé; Michael Veness; Paul Nghiem Journal: Nat Rev Dis Primers Date: 2017-10-26 Impact factor: 52.329
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: Monika Dudzisz-Sledz; Paweł Sobczuk; Katarzyna Kozak; Tomasz Switaj; Hanna Kosela-Paterczyk; Anna Malgorzata Czarnecka; Slawomir Falkowski; Paweł Rogala; Tadeusz Morysinski; Mateusz Jacek Spalek; Marcin Zdzienicki; Tomasz Goryn; Marcin Zietek; Bozena Cybulska-Stopa; Stanisław Klek; Grazyna Kaminska-Winciorek; Barbara Ziolkowska; Anna Szumera-Cieckiewicz; Piotr Rutkowski Journal: Cancers (Basel) Date: 2022-01-14 Impact factor: 6.639