Merkel cell carcinoma of the head and neck: A retrospective case series

Brissett, Anthony E.; Olsen, Kerry D.; Kasperbauer, Jan L.; Lewis, Jean E.; Goellner, John R.; Spotts, Bruce E.; Weaver, Amy L.; Strome, Scott E.

doi:10.1002/hed.10153

Cited by 100 publications

(89 citation statements)

References 38 publications

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“…The median follow-up was 16 to 18 months, but the literature suggests that the majority of lymph node recurrences appear within 1 year of diagnosis. 17,22,[45][46][47] In the largest published MCC meta-analysis, it was found that the median time to lymph node recurrence was 7 months, with 75% of these events occurring within 12 months of initial treatment. 9 Nevertheless, with longer follow-up, an increase in recurrence rates may be reported.…”

Section: Discussionmentioning

confidence: 99%

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Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Fang

Lemos

Douglas

et al. 2010

Cancer

145

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BACKGROUND:Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high risk of lymph node involvement. To the authors' knowledge, few data have been published to date regarding the optimal regional therapy for lymph node‐positive patients. This cohort study was performed to analyze the outcomes of patients with lymph node‐positive MCC treated with lymph node irradiation as definitive therapy compared with completion lymphadenectomy (CLND).METHODS:Fifty patients with lymph node involvement of MCC at presentation and adequate follow‐up data were included in this analysis. Forty‐three of these patients were enrolled and followed prospectively. Twenty‐six patients presented with microscopic lymph node disease, and 24 patients presented with palpable lymph node involvement.RESULTS:Regional control for patients with microscopically involved lymph nodes was 100% regardless of treatment modality—definitive lymph node irradiation (n = 19) or CLND ± radiotherapy (n = 7) with median follow‐up of 18 months. Patients with clinically positive lymph nodes had 2‐year regional recurrence‐free survival rate of 78% and 73% in the definitive lymph node irradiation (n = 9) and CLND ± radiotherapy (n = 15) groups, respectively (P = .8) with a median follow‐up of 16 months.CONCLUSIONS:To the best of the authors' knowledge, the current study is the largest series published to date of radiation monotherapy as regional treatment for lymph node‐positive MCC. Lymph node irradiation alone to positive regional lymph nodes was found to confer an excellent regional control rate that was comparable to CLND for both microscopic and palpable lymph node disease. There was no difference noted with regard to overall survival. Given their similar efficacy, the choice between these lymph node therapies may be based on the clinical scenario and anticipated side effect profiles. Cancer 2010. © 2010 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

“…Patients present with lymph node disease in 19% to 33% 9,13,[16][17][18] of cases. Traditional recommended practice for the regional therapy for lymph node-positive disease is completion lymphadenectomy (CLND) with or without adjuvant radiotherapy.…”

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confidence: 99%

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Fang

Lemos

Douglas

et al. 2010

Cancer

145

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“…Slight male predominance, mean age 68 years and almost half of the tumors located in the head and neck region. 11,14 During the course of the disease 47% of the patients progressed to metastatic dissemination, local recurrence was recorded in 42% patients. These data are also consistent with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Radical surgery is the recommended procedure to improve prediction of better survival in MCC. 13,14 Previously, cytogenetic analyses have not shown any recurrent reciprocal translocations in MCC that would generate fusion genes or lead to activation of oncogenes. Little is thus known about the chromosomal and genetic alterations in MCC.…”

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confidence: 99%

Recurrent DNA copy number changes revealed by comparative genomic hybridization in primary Merkel cell carcinomas

et al. 2004

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Comparative genomic hybridization (CGH) was used to search for gains, high-level amplifications and losses of DNA sequences along all chromosome arms in 19 primary Merkel cell carcinomas (MCC). Extensive genetic aberrations, with a mean value of 5.571.1 changes per tumor were detected in 13 out of the 19 samples analyzed. Our CGH results reveal several new and other previously known chromosomal regions that are involved in the pathogenesis of MCC. The majority of the alterations were gains of whole chromosomes or whole chromosome arms. Compared to losses, the frequency of DNA copy number gains was two-fold. DNA sequence copy number gains were most common in chromosomes 6 (42%), 1 (37%), and 5 (32%). The most frequent minimal common regions of gains were 6pterqter (42%), 1q11q31 (32%), and 5p (32%). No recurrent high-level amplifications were observed. High-level amplifications of small chromosomal regions were found in four samples out of the 19 tumors analyzed (21%). Amplifications affected 1q22q24 (5%), 4p (5%), and 5p (5%). Losses most frequently affected chromosomes 13 (21%) and 4 (16%). Minimal common regions with the most frequent losses were 13q13q31 (21%), 4q (16%), and 16q (11%). No significant statistical correlation between genomic aberrations and clinicopathological factors was revealed, despite the fact that there was an obvious tendency towards it. Primary MCC expressing DNA alterations were predominantly distinguished in large tumors, and risk of metastatic dissemination was three-fold compared to tumors with no DNA alterations.

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“…Mohs micrographic technique has been recommended especially in areas with high demands on aesthetics, such as localized tumors of head and neck. Brisset et al 48 however, point to the lower survival of patients treated with Mohs technique compared to patients with extensive radical excision supplemented by cervical block dissection.…”

Section: Discusionmentioning

confidence: 99%

Merkel cell carcinoma. A review

Pink¹,

Ehrmann²,

Molitor³

et al. 2012

BIOMED PAP

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Background. Merkel cell carcinoma (MCC) is a rare potentially fatal skin tumour affecting older mainly white people and younger immunosuppressed individuals. While uncommon, the incidence is increasing relative to melanoma and with twice the lethality. The benign appearance of the tumour usually on exposed skin parts, contrasting with its extensive microscopic invasion, can delay timely diagnosis. Recurrent MCC is currently attributed to the recently discovered Merkel cell polyomavirus This brief review of MCC covers the history, epidemiology,etiology,clinical and histological features, treatment and prognosis. Methods. Literature search using PubMed and search words Merkel cell carcinoma (MCC), etiology, treatment for the years 1972 to 2010. Results and conclusion. Merkel cell carcinoma is a rare malignancy with uncertain prognosis. Due to the uncommon occurrence and dearth of randomized studies, there is no agreement on optimal treatment. The tumor has only recently been included in the international classification of tumors (NCCN). The treatment approaches found to be best are radical surgery of primary tumor, drainage of lymph node extension and possibly adjuvant loco-regional radiotherapy. The basis of successful treatment however, remains prevention regular dermatological examination in immunosuppressed patients and early initiation of combination therapy, based on radical surgery supplemented by radiotherapy and palliative chemotherapy in the last resort.

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Merkel cell carcinoma of the head and neck: A retrospective case series

Abstract: WLE and dissection of the lymphatic drainage basin provided the best overall survival.

Cited by 100 publications

References 38 publications

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Radiation monotherapy as regional treatment for lymph node‐positive Merkel cell carcinoma

Recurrent DNA copy number changes revealed by comparative genomic hybridization in primary Merkel cell carcinomas

Merkel cell carcinoma. A review

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