G Paul Wright1, Matthew P Holtzman2. 1. Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, USA; Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, MI, USA; Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: wrightg9@msu.edu. 2. Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Abstract
BACKGROUND: Definitive radiotherapy has been suggested as a treatment alternative to surgical resection in Merkel cell carcinoma (MCC). METHODS: Patients with MCC were identified from the National Cancer Database. Propensity score matching accounting for age, Charlson-Deyo score, grade, and AJCC stage was used to match patients in 1:1 fashion by primary treatment (surgery vs. radiotherapy). RESULTS: There were 1227 patients in each group. Median overall survival was improved with surgical resection in stage I/II (76 vs. 25 months, p < 0.001) and stage III disease (30 vs. 15 months, p < 0.001). For stage I/II, 5- and 8-year overall survival were 61% and 42%, in the surgical resection and 32% and 25% in the definitive radiotherapy groups, respectively. For stage III, 5- and 8-year overall survival were 34% and 21% for surgical resection and 19% and 16% in the radiotherapy group, respectively. CONCLUSIONS: Surgical resection for MCC improves median survival compared to definitive radiotherapy while marginally improving long-term survival.
BACKGROUND: Definitive radiotherapy has been suggested as a treatment alternative to surgical resection in Merkel cell carcinoma (MCC). METHODS:Patients with MCC were identified from the National Cancer Database. Propensity score matching accounting for age, Charlson-Deyo score, grade, and AJCC stage was used to match patients in 1:1 fashion by primary treatment (surgery vs. radiotherapy). RESULTS: There were 1227 patients in each group. Median overall survival was improved with surgical resection in stage I/II (76 vs. 25 months, p < 0.001) and stage III disease (30 vs. 15 months, p < 0.001). For stage I/II, 5- and 8-year overall survival were 61% and 42%, in the surgical resection and 32% and 25% in the definitive radiotherapy groups, respectively. For stage III, 5- and 8-year overall survival were 34% and 21% for surgical resection and 19% and 16% in the radiotherapy group, respectively. CONCLUSIONS: Surgical resection for MCC improves median survival compared to definitive radiotherapy while marginally improving long-term survival.
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