Multimodality Management of Merkel Cell Carcinoma

Ott, Mark J.; Tanabe, Kenneth K.; Gadd, Michele A.; Stark, Paul; Smith, Barbara L.; Finkelstein, Dianne M.; Souba, Wiley W.

doi:10.1001/archsurg.134.4.388

Cited by 180 publications

(188 citation statements)

References 16 publications

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“…Five patients (55%) with small tumors (size o2 cm) showed no DNA changes. In compliance with previous studies, 11,25 large tumor size and nodal disease at the presentation had a negative impact on overall survival in MCC patients.…”

Section: Discussionsupporting

confidence: 87%

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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Section: Discussionsupporting

confidence: 87%

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

et al. 2004

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“…3,6,7 MCC tends to affect the elderly, with a median age at presentation between 67 and 76 years (range, 8-98 years). 3,[7][8][9][10][11][12][13] It usually occurs in sun-damaged skin of the head and neck region or extremities, but it also involves sun-pro-tected sites, such as the buttocks. 3,6,7,9,[11][12][13][14][15][16][17][18][19] Recently, a polyomavirus has been identified that is integrated into the genome of MCC and may play a role in the pathogenesis of these tumors.…”

mentioning

confidence: 99%

Merkel cell carcinoma

Andea

Coit

Amin

et al. 2008

Cancer

196

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BACKGROUND. Currently, little is known regarding the potential prognostic value of histologic features in primary cutaneous neuroendocrine (Merkel cell) carcinomas (MCC). METHODS. In a retrospective review of the tumor histology and clinical outcome data (median follow‐up, 51 months; range, 3‐224 months) of 156 patients with a diagnosis of MCC, the following histologic features were evaluated: tumor thickness, tumor size (greatest dimension of the tumor), microanatomic compartment involved by tumor (dermis and/or subcutis and/or deeper), tumor growth pattern (nodular circumscribed vs infiltrative), lymphovascular invasion (LVI), tumor‐infiltrating lymphocytes, tumor necrosis, ulceration, and solar elastosis. RESULTS. The overall 5‐year survival rate was 67.5%. On univariate analysis, parameters that were associated significantly with survival were tumor thickness (P = .001), tumor size (P = .0002), deepest anatomic compartment involved by tumor (P = .0003), tumor growth pattern (P = .003), LVI (P < .00001), tumor‐infiltrating lymphocytes (P = .05), and solar elastosis (P = .04). On multivariate analysis, the presence of a nodular growth pattern, low tumor depth, and absence of LVI were associated with longer survival. CONCLUSIONS. In addition to the known prognostic value of tumor stage, 3 histologic features were identified to have prognostic significance: tumor thickness (depth of tumor invasion), the presence of LVI, and tumor growth pattern. Cancer 2008. © 2008 American Cancer Society.

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“…Results have indicated that adjuvant RT, following initial surgery and resection for recurrent MCC and palliation is beneficial (21). A previous study reported that a radiation dose of 45 Gy had significant impact on local control and prolonged survival in nine patients, whereas a subset of 7 patients who received <45 Gy had a poorer outcome (22). Our patient received 54, 30, 50, 30 and 30 Gy for inguinal LNs, vertebrae, right dorsal thigh, humerus and liver, respectively.…”

Section: Discussionmentioning

confidence: 99%

Merkel cell carcinoma with lymph node metastasis in the absence of a primary site: Case report and literature review

Zhao

Meng

2012

Oncology Letters

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Abstract. Merkel cell carcinoma (MCC) is a rare malignant skin neoplasm with the potential for local recurrence, spreading to regional lymph nodes (LNs) and distant metastases. Although it has been identified in various anatomical sites, LN metastatic MCC in the absence of a primary site is extremely rare. The present case reports a 54-year-old male who initially underwent histological examination of a biopsy specimen from the right inguinal LNs. A diagnosis of metastatic small cell carcinoma was made. Nine months later, this diagnosis was changed to MCC with multiple metastases following observation of a tumour mass in the right dorsal thigh. Additionally, in the present study a summary is provided of 23 published cases of MCC with initial LN metastasis in the absence of a primary site, with details of clinical characteristics, natural history and pertinent therapy of this uncommon tumour. The present patient with LN metastatic MCC in the absence of a primary site and the other reported cases demonstrate that although multimodal treatment with surgery, radiotherapy (RT) and chemotherapy provides excellent local control, local recurrence and distant metastases commonly develop in this uncommon tumour. LN metastatic MCC in the absence of a primary site is a highly malignant disease and the role of adjuvant postoperative RT and/or chemotherapy remains to be fully determined.

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Multimodality Management of Merkel Cell Carcinoma

Cited by 180 publications

References 16 publications

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

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

Merkel cell carcinoma

Merkel cell carcinoma with lymph node metastasis in the absence of a primary site: Case report and literature review

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