Babu Singh1, Muhammad M Qureshi2, Minh Tam Truong2, Debjani Sahni3. 1. Department of Dermatology, Boston University Medical Center, Boston, Massachusetts. 2. Department of Radiation Oncology, Boston University Medical Center, Boston, Massachusetts. 3. Department of Dermatology, Boston University Medical Center, Boston, Massachusetts. Electronic address: dsahni@bu.edu.
Abstract
BACKGROUND: The optimal surgical approach (wide local excision [WLE] vs Mohs micrographic surgery [MMS]) for treating Merkel cell carcinoma (MCC) is yet to be determined. OBJECTIVE: To compare survival outcomes in patients with early-stage MCC treated with MMS versus with WLE. METHODS: A retrospective review of all cases in the National Cancer Database (NCDB) of MCC of clinical stage I or II MCC treated with WLE or MMS was performed. RESULTS: A total of 1795 cases of stage I or II MCC who underwent WLE (n = 1685) or MMS (n = 110) were identified. There was no difference in residual tumor on surgical margins between the 2 treatment groups (P = .588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted hazard ratio, 1.02; 95% confidence interval, 0.72-1.45; P = .897). There was no difference in overall survival between the 2 groups on propensity score-matched analysis. LIMITATIONS: Disease-specific survival was not reported, as these data are not available in the National Cancer Database. CONCLUSIONS: MMS appears to be as effective as WLE in treating early-stage MCC.
BACKGROUND: The optimal surgical approach (wide local excision [WLE] vs Mohs micrographic surgery [MMS]) for treating Merkel cell carcinoma (MCC) is yet to be determined. OBJECTIVE: To compare survival outcomes in patients with early-stage MCC treated with MMS versus with WLE. METHODS: A retrospective review of all cases in the National Cancer Database (NCDB) of MCC of clinical stage I or II MCC treated with WLE or MMS was performed. RESULTS: A total of 1795 cases of stage I or II MCC who underwent WLE (n = 1685) or MMS (n = 110) were identified. There was no difference in residual tumor on surgical margins between the 2 treatment groups (P = .588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted hazard ratio, 1.02; 95% confidence interval, 0.72-1.45; P = .897). There was no difference in overall survival between the 2 groups on propensity score-matched analysis. LIMITATIONS: Disease-specific survival was not reported, as these data are not available in the National Cancer Database. CONCLUSIONS: MMS appears to be as effective as WLE in treating early-stage MCC.
Authors: Elena Dellambra; Maria Luigia Carbone; Francesca Ricci; Francesco Ricci; Francesca Romana Di Pietro; Gaia Moretta; Sofia Verkoskaia; Elisa Feudi; Cristina M Failla; Damiano Abeni; Luca Fania Journal: Biomedicines Date: 2021-06-23