Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada.
Laryngoscope. 2013 Dec;123(12):3043-8. doi: 10.1002/lary.24233. Epub 2013 Oct 10.
OBJECTIVES/HYPOTHESIS: To identify or confirm any new or suggested independent histopathological predictors in Merkel cell carcinoma (MCC) of the head and neck (HN) correlated with outcome.
Retrospective chart and pathology review.
Between 1990 and 2010, 58 patients with Merkel cell carcinoma of the head and neck HNMCC were identified for study. Pathologic specimens were reviewed and evaluated for independent prognostic factors and correlated with locoregional recurrence and disease-specific survival.
The 2- and 5-year disease-specific survival (DSS) rates were 72.7% and 63.6%, respectively. The local and regional recurrence rates were 12.0% and 24.1%, respectively. A total of 25.9% of the patients developed distant metastases during follow-up. Tumor size (< 1 cm vs. > 1 cm) and the presence of a positive deep resection margin were independently found to be significantly associated with regional recurrence (P = 0.01 and P = 0.04, respectively). No other prognostic factors could be identified.
Adjuvant radiotherapy cannot remediate a positive resection margin. Given these results, consideration for revision surgery should be considered for a positive deep margin. Frozen section analysis may help to define the margins in this invasive and aggressive disease.
目的/假设：确定或确认与头颈部（HN）Merkel 细胞癌（MCC）结果相关的任何新的或建议的独立组织病理学预测因子。
回顾性图表和病理审查。
在 1990 年至 2010 年期间，确定了 58 例头颈部 Merkel 细胞癌 HN MCC 患者进行研究。对病理标本进行了回顾和评估，以确定独立的预后因素，并与局部区域复发和疾病特异性生存率相关。
2 年和 5 年疾病特异性生存率（DSS）分别为 72.7%和 63.6%。局部和区域复发率分别为 12.0%和 24.1%。在随访期间，共有 25.9%的患者发生远处转移。肿瘤大小（<1cm 与>1cm）和存在阳性深部切缘被独立发现与区域复发显著相关（P=0.01 和 P=0.04）。没有发现其他预后因素。
辅助放疗不能纠正阳性切缘。鉴于这些结果，对于阳性深部切缘应考虑进行修正手术。冰冻切片分析可能有助于在这种侵袭性和侵袭性疾病中确定边缘。
