Jouary Thomas, Kubica Emeline, Dalle Stéphane, Pages Cecile, Duval-Modeste Anne-Benedicte, Guillot Bernard, Mansard Sandrine, Saiag Philippe, Aubin François, Bedane Christophe, Dalac Sophie, Dompmartin Anne, Granel-Brocard Florence, Lok Catherine, Stoebner Pierre-Emmanuel, Lacour Jean-Philippe, Leccia Marie-Therese, Diallo Abou, Ezzedine Khaled, Mateus Christina
Department of Dermatology, Hôpital Saint André, CHU Bordeaux, Bordeaux, France.
Acta Derm Venereol. 2015 Sep;95(7):835-40. doi: 10.2340/00015555-2099.
The prognostic value of the sentinel lymph node in Merkel cell carcinoma (MCC) has been examined previously in heterogeneous retrospective studies. The current retrospective study included a homogeneous population of patients with a localized MCC, all staged with sentinel lymph node biopsy. Factors associated with 3-year progression-free survival were analysed using logistic regression. The sentinel lymph node was positive in 32% of patients. The recurrence rate was 26.9%. In first analyses (n = 108), gender (p = 0.0115) and the presence of immunosuppression (p = 0.0494) were the only significant independent factors. In further analyses (n = 80), excluding patients treated with regional radiotherapy, sentinel lymph node status was the only significant prognostic factor (p = 0.0281). Immunosuppression and positive sentinel lymph node are associated with a worse prognosis in patients with MCC. Nodal irradiation impacts on the prognostic value of the sentinel lymph node status.
前哨淋巴结在默克尔细胞癌（MCC）中的预后价值先前已在异质性回顾性研究中进行了检验。当前的回顾性研究纳入了一组均一的局限性MCC患者，所有患者均接受了前哨淋巴结活检分期。使用逻辑回归分析与3年无进展生存期相关的因素。32%的患者前哨淋巴结呈阳性。复发率为26.9%。在首次分析（n = 108）中，性别（p = 0.0115）和免疫抑制的存在（p = 0.0494）是仅有的显著独立因素。在进一步分析（n = 80）中，排除接受区域放疗的患者后，前哨淋巴结状态是唯一显著的预后因素（p = 0.0281）。免疫抑制和前哨淋巴结阳性与MCC患者的预后较差相关。淋巴结照射会影响前哨淋巴结状态的预后价值。
