Merkel 细胞癌的完全淋巴结清扫术。
Completion lymph node dissection for merkel cell carcinoma.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, 48220, MI, USA.
Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmity, Harvard Medical School, Boston, MA, USA.
出版信息
Am J Surg. 2020 Oct;220(4):982-986. doi: 10.1016/j.amjsurg.2020.02.018. Epub 2020 Feb 15.
BACKGROUND
Sentinel lymph node biopsy (SLNB) is widely used for Merkel cell carcinoma (MCC), however in SLNB positive MCC the role of completion lymph node dissection (CLND) with or without adjuvant radiation therapy is unclear.
OBJECTIVE
Our goal was to determine the impact of CLND and adjuvant radiation therapy on survival in SLNB positive MCC.
MATERIALS AND METHODS
We examined 447 patients with MCC with a positive SLNB in the National Cancer Data Base from 2012 to 2015. We compared patients who underwent CLND versus observation with or without adjuvant radiation.
RESULTS
Compared with CLND and adjuvant radiation (reference) treatment with observation (HR 3.54, CI 1.36-9.18) or CLND alone (HR 2.54, CI 1.03-6.27) were associated with worse overall survival after adjusting for clinicopathologic differences. In contrast treatment with adjuvant radiation alone without CLND was not associated with worse overall survival (HR 1.70, CI 0.74-3.92) compared with CLND and adjuvant radiation (reference).
CONCLUSIONS
In SLNB positive MCC, CLND alone is associated with worse survival compared with treatment with adjuvant radiation or both CLND and adjuvant radiation.
背景
前哨淋巴结活检（SLNB）被广泛应用于 Merkel 细胞癌（MCC），然而在 SLNB 阳性的 MCC 中，完成淋巴结清扫术（CLND）加或不加辅助放疗的作用尚不清楚。
目的
我们的目的是确定 CLND 和辅助放疗对 SLNB 阳性 MCC 患者生存的影响。
材料与方法
我们在 2012 年至 2015 年期间，在国家癌症数据库中检查了 447 例 SLNB 阳性的 MCC 患者。我们比较了接受 CLND 与观察（或有或无辅助放疗）的患者。
结果
与 CLND 和辅助放疗（参照）相比，观察（HR 3.54，CI 1.36-9.18）或仅行 CLND（HR 2.54，CI 1.03-6.27）治疗与调整临床病理差异后的总生存率降低相关。相比之下，单独接受辅助放疗而不进行 CLND 治疗与 CLND 和辅助放疗（参照）相比，总生存率并没有更差（HR 1.70，CI 0.74-3.92）。
结论
在 SLNB 阳性的 MCC 中，与接受辅助放疗或 CLND 和辅助放疗治疗相比，单独行 CLND 与生存率降低相关。
Zotero 插件