Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2020 Aug;163(2):364-371. doi: 10.1177/0194599820913622. Epub 2020 Mar 31.
To evaluate the management and recurrence outcomes of head and neck Merkel cell carcinoma (HN-MCC) at a single institution.
A retrospective review of outcomes in patients with HN-MCC.
A tertiary center from May 1990 to December 2018.
Electronic medical records of patients with HN-MCC were reviewed.
Sixty cases were included, with 67% (40 of 60) males and a mean age of 73.3 years. Imaging had a moderate sensitivity and specificity for detection of occult disease when compared with histopathologic analysis. Forty-two percent (25 of 60) of patients underwent neck dissection, and 12% (7 of 60) had a sentinel lymph node biopsy (SLNB). There was a high rate of negative SLNB findings. The majority of patients were treated with surgery alone (29 of 60), followed by a cohort (21 of 60) treated with surgery plus adjuvant treatment, and 10 of 60 patients were treated with radiation therapy with or without chemotherapy. Recurrence-free survival was 50%, 45%, and 42% at 1, 2, and 5 years.
We report higher recurrence rates and higher negative SLNB result rates than other studies. Our results affirm that imaging may not be a substitute for SLNB and that it had an intermediate ability to identify the occult disease. Traditional predictors, including SLNB and cervical node pathology, may not identify patients at risk for recurrence in HN-MCC. We report similar recurrence rates in patients who had treatment of the cervical nodes by radiation therapy or neck dissection as compared with those who did not receive neck treatment.
评估单一机构内头颈部 Merkel 细胞癌（HN-MCC）的治疗管理和复发结局。
对 HN-MCC 患者结局的回顾性研究。
1990 年 5 月至 2018 年 12 月的三级中心。
回顾性分析 HN-MCC 患者的电子病历。
共纳入 60 例患者，其中 67%（40/60）为男性，平均年龄为 73.3 岁。与组织病理学分析相比，影像学检查对隐匿性疾病的检测具有中等的敏感性和特异性。42%（25/60）的患者行颈部清扫术，12%（7/60）行前哨淋巴结活检（SLNB）。SLNB 结果多为阴性。大多数患者单独接受手术治疗（29/60），其次是手术加辅助治疗组（21/60），10 例患者接受单纯放疗或放化疗。1、2、5 年无复发生存率分别为 50%、45%和 42%。
我们报告的复发率和阴性 SLNB 结果率高于其他研究。我们的结果证实，影像学检查可能不能替代 SLNB，且其识别隐匿性疾病的能力中等。包括 SLNB 和颈部淋巴结病理在内的传统预测因素可能无法识别 HN-MCC 患者的复发风险。我们报告了接受颈部淋巴结放疗或清扫术治疗与未接受颈部治疗的患者的复发率相似。
