Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A.;
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A.
Anticancer Res. 2023 Apr;43(4):1549-1553. doi: 10.21873/anticanres.16304.
BACKGROUND/AIM: Skin cancers are the most common malignancy of the hand and wrist. Merkel cell carcinoma (MCC) is a rare, aggressive non-melanoma skin cancer arising from cutaneous neuroendocrine cells and is known for local and distant recurrence. The purpose of the current study was to examine the treatment outcome of patients with MCC of the hand and wrist.
We reviewed 25 patients (18 males:7 females) with MCC that occurred in the hand and wrist. The mean age at the time of biopsy of 71±11 years.
Tumors were located on the hand (n=13), finger/thumb (n=9), and wrist (n=3). Local control included wide local excision (n=22). This included 21 non-amputation resections and one 5 digit ray amputation. Sentinel lymph node biopsy was performed in 21 patients with positive nodal disease in seven cases. Adjuvant radiotherapy was delivered to the primary site in 17 patients and additionally to the regional lymph node basin in six patients. Recurrence within five years was noted in 40% of patients (mean time to recurrence 18.4±20.6 months). Recurrence-free and disease-specific survival rates at 5-years were 54.8% and 67.6%.
MCC is a rare cutaneous neuroendocrine carcinoma with a high propensity for regional nodal spread. Despite aggressive local treatment, adjuvant radiotherapy to the primary site and regional nodes, MCC of the hand and wrist has a high rate of recurrence and mortality within five years of diagnosis.
背景/目的：皮肤癌是手部和腕部最常见的恶性肿瘤。默克尔细胞癌（MCC）是一种罕见的侵袭性非黑色素瘤皮肤癌，来源于皮肤神经内分泌细胞，以局部和远处复发为特征。本研究的目的是探讨手部和腕部 MCC 患者的治疗结果。
我们回顾了 25 例手部和腕部发生 MCC 的患者（男性 18 例，女性 7 例）。活检时的平均年龄为 71±11 岁。
肿瘤位于手部（n=13）、手指/拇指（n=9）和手腕（n=3）。局部控制包括广泛局部切除（n=22）。这包括 21 例非截肢性切除和 1 例 5 指射线截肢。21 例患者进行了前哨淋巴结活检，7 例患者有阳性淋巴结疾病。17 例患者接受了局部原发灶辅助放疗，6 例患者接受了区域淋巴结引流区辅助放疗。5 年内有 40%的患者出现复发（平均复发时间为 18.4±20.6 个月）。5 年无复发生存率和疾病特异性生存率分别为 54.8%和 67.6%。
MCC 是一种罕见的皮肤神经内分泌癌，具有高度的区域淋巴结扩散倾向。尽管进行了积极的局部治疗，包括辅助放疗原发灶和区域淋巴结，手部和腕部 MCC 的复发率和 5 年内死亡率仍很高。
