Regional lymph node irradiation in locally advanced Merkel cell carcinoma reduces regional and distant relapse and improves disease-specific survival

Incidence and risk factors for early mortality in adults with skin Merkel cell carcinoma: A SEER-based study

“…Cramer et al 3 reported that complete node dissection alone may be associated with poorer survival, compared with radiotherapy alone. Some other studies 4,5 reported that complete node dissection or definitive radiotherapy had a similar MCC prognosis when sentinel node biopies were positive.…”

“…The key to the controversy is to distinguish whether high disease burden is present, namely bulky nodes, multiple nodes ($2), or extracapsular extension. 5 Definitive radiotherapy or regional node removal are both viable choices for relatively low disease burden, but combination might be a better choice for a high disease burden. However, the influence of radiation and node dissection combined therapy on prognosis was also controversial, as per some of the recent studies.…”

“…However, the influence of radiation and node dissection combined therapy on prognosis was also controversial, as per some of the recent studies. [3][4][5] Further identification of the high-risk factors for early death in MCC would be essential to optimize care and improve clinical outcomes.…”

Merkel Cell Carcinoma: An Immunotherapy Fairy-Tale?

“…In this trial, adjuvant RT significantly improved OS while CLND did not. Finally, another retrospective trial ( 63 ) performed on 72 patients and published in 2021 showed that RT improved OS. As in previously mentioned work, patients underwent observation, RT alone, CLND alone, or RT + CLND.…”

Multimodal Strategy in Localized Merkel Cell Carcinoma: Where Are We and Where Are We Heading?

“…On the other hand, another study showed an improvement in 3-year disease-specific survival (DSS) among node-positive patients (76.2 vs. 48.1%; p = 0.035), as well as an improvement of locoregional control in patients with either pathologically or clinically positive nodes who received aRT compared to those who did not [ 70 ]. Andruska and colleagues showed that aRT on regional lymph nodes, including both definitive RT and RT after CLND, improved regional RFS (HR: 0.07; p = 0.003), distant RFS (HR: 0.28; p = 0.01), DFS (HR: 0.23; p = 0.002) and DSS (HR: 0.23; p = 0.03) without any difference between definitive RT and RT after CLND [ 81 ]. In addition, RT after CLND improved DFS and DSS among patients with high-risk factors such as extra-nodal involvement, ≥2 positive lymph nodes and foci of nodal disease >0.5 cm.…”