Kleffner F, Schürholz J, Burckhardt S, Mauch C, Schlaak M
Klinik und Poliklinik für Dermatologie und Venerologie, Hauttumorzentrum im CIO Köln Bonn, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Hautarzt. 2014 Sep;65(9):823-30; quiz 831-2. doi: 10.1007/s00105-014-2854-8.
Merkel cell carcinoma is a rare aggressive malignant neuroendocrine skin tumor, which can metastasize to lymph nodes early and often shows local recurrence. The prognosis depends on tumor size and disease stage. The majority of recurrences appear during the first 2 years after the primary diagnosis. The 5-year survival rate for primary tumor < 2 cm is 66-75 % and for primary tumors > 2 cm is 50-60 %. With lymph node metastases the 5-year survival rate is 42-52 %, while with distant metastases it drops to 17-12 %. Extensive staging inclusive sentinel lymph node biopsy is essential to assess the risk for distant metastasis and to allow the best recommendations for therapy. After surgical treatment with adequate safety margin, subsequent adjuvant radiation therapy of the tumor region and lymphatic draining basin is recommended to reduce the risk of local recurrence and lymphatic spread.
默克尔细胞癌是一种罕见的侵袭性恶性神经内分泌皮肤肿瘤,可早期转移至淋巴结,且常出现局部复发。预后取决于肿瘤大小和疾病分期。大多数复发发生在初次诊断后的头2年。原发肿瘤<2 cm的5年生存率为66 - 75%,原发肿瘤>2 cm的5年生存率为50 - 60%。发生淋巴结转移时,5年生存率为42 - 52%,而发生远处转移时则降至17 - 12%。包括前哨淋巴结活检在内的全面分期对于评估远处转移风险以及给出最佳治疗建议至关重要。在进行具有足够安全切缘的手术治疗后,建议对肿瘤区域和淋巴引流区进行后续辅助放疗,以降低局部复发和淋巴扩散的风险。