Scampa Matteo, Merat Rastine, Tzika Evangelia, Kalbermatten Daniel F, Oranges Carlo M
Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
Dermato-Oncology Unit, Division of Dermatology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
JAAD Int. 2022 Feb 23;7:13-21. doi: 10.1016/j.jdin.2021.12.010. eCollection 2022 Jun.
Merkel cell carcinoma of lower limb and hip skin is a rare skin tumor that has a high recurrence rate.
To assess epidemiology and survival outcomes of the lower limb and hip Merkel cell carcinoma, which are less addressed in the literature.
The Surveillance, Epidemiology, and End Results database was searched for all cases of skin Merkel cell carcinoma between 2000 and 2018. Demographic and clinicopathologic features were compared between lower limb and other skin localizations using the test or χ test. The overall survival (OS) of lower limb Merkel cell carcinoma was calculated using the Kaplan-Meier method. Subgroups were compared using the log rank test. Multivariate cox regression was used to identify independent prognostic factors.
In total, 976 patients were identified. The mean age was 72.7 years. The median OS was 68 months, better than that of other localizations. Older age, regional lymph node, and distant metastasis were associated with low OS. Surgery with >1-cm margins, when associated with radiotherapy, had the best OS. Age, tumor size, lymph node status, presence of metastasis, and treatment sequence were identified as independent prognostic factors.
Lower limb and hip Merkel cell carcinomas have better OS than tumors in other skin localizations. In this dataset, the best OS was ensured using surgery with >1-cm margins and adjuvant radiotherapy.
下肢及臀部皮肤默克尔细胞癌是一种罕见的皮肤肿瘤，复发率高。
评估下肢及臀部默克尔细胞癌的流行病学及生存结局，这在文献中较少涉及。
在监测、流行病学和最终结果数据库中检索2000年至2018年间所有皮肤默克尔细胞癌病例。使用检验或χ检验比较下肢与其他皮肤部位的人口统计学和临床病理特征。采用Kaplan-Meier方法计算下肢默克尔细胞癌的总生存期（OS）。使用对数秩检验比较亚组。多变量cox回归用于确定独立的预后因素。
共识别出976例患者。平均年龄为72.7岁。中位总生存期为68个月，优于其他部位。年龄较大、区域淋巴结转移和远处转移与总生存期较低相关。手术切缘>1 cm并联合放疗时，总生存期最佳。年龄、肿瘤大小、淋巴结状态、转移情况和治疗顺序被确定为独立的预后因素。
下肢及臀部默克尔细胞癌的总生存期优于其他皮肤部位的肿瘤。在该数据集中，手术切缘>1 cm并联合辅助放疗可确保最佳总生存期。
