Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
Am J Surg. 2013 Nov;206(5):752-7. doi: 10.1016/j.amjsurg.2013.02.005. Epub 2013 Jul 5.
There is limited evidence that Merkel cell carcinoma (MCC) arising from a nodal basin without evidence of a primary cutaneous (PC) site has better prognosis. We present our experience at 2 tertiary care referral centers with stage III MCC with and without a PC site.
Fifty stage III MCC patients were identified between 1996 and 2011. Clinical data were analyzed, with primary endpoints being disease-free survival and overall survival.
Of stage III patients, 34 patients presented with a PC site and 16 patients with an unknown primary (UP) site. Treatment strategies varied; of patients with UP vs. PC sites, 25% vs. 44% underwent combined regional lymphadenectomy and radiation, with an additional 25% vs. 15% receiving chemotherapy. The median disease-free survival for a UP site was not reached vs. 15 months for a PC site (hazards ratio = .48, P = .18). The median overall survival for a UP site was not reached vs 21 months for a PC site (hazards ratio = .34, P = .03). Multivariate analysis showed that UP status was a significant factor in overall survival (P = .002).
Stage III MCC with a UP site portends a better prognosis than MCC with a PC site.
有限的证据表明，无原发性皮肤（PC）部位证据的淋巴结内 Merkel 细胞癌（MCC）预后较好。我们在 2 个三级转诊中心报告了有和没有 PC 部位的 III 期 MCC 的经验。
1996 年至 2011 年间，共确定了 50 例 III 期 MCC 患者。分析了临床资料，主要终点是无病生存和总生存。
在 III 期患者中，34 例患者有 PC 部位，16 例患者有未知原发性（UP）部位。治疗策略不同；UP 与 PC 部位患者中，25%与 44%接受了区域淋巴结清扫术加放疗，另有 25%与 15%接受了化疗。UP 部位的中位无病生存期未达到，而 PC 部位为 15 个月（风险比=0.48，P=0.18）。UP 部位的中位总生存期未达到，而 PC 部位为 21 个月（风险比=0.34，P=0.03）。多变量分析显示，UP 状态是总生存的一个显著因素（P=0.002）。
无 PC 部位的 III 期 MCC 预后优于有 PC 部位的 MCC。
