MCC with SNL metastasis: CLND, RT yield similar outcomes

  • Lee JS & al.
  • Ann Surg Oncol
  • 17.12.2018

  • von Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Completion lymph node dissection (CLND) and radiation therapy (RT) are associated with similar outcomes in patients with Merkel cell carcinoma (MCC) with sentinel lymph node (SLN) metastasis.

Why this matters

  • Relative treatment benefits are unclear in this patient population, but the presence of positive non-SLNs appears to be the most important prognostic factor.

Key results

  • CLND and RT were associated with similar 5-year MCC-specific survival (MCCSS; 71% vs 64%; P=1.0), DFS (52% vs 61%; P=0.8), nodal recurrence-free survival (76% vs 91%; P=0.3), and distant recurrence-free survival (DRFS; 65% vs 75%; P=0.3).
  • In patients who underwent CLND, positive non-SLNs were associated with worse 5-year MCCSS (39% vs 87%; P<.001 dfs vs and drfs compared with negative non-slns. style="list-style-type:circle;">
  • Positive SLNs were independently associated with MCCSS (HR, 5.9; P=.001), DFS (HR, 3.1; P=.003), and DRFS (HR, 4.2; P=.008) after CLND in multivariate analysis.

Study design

  • 163 patients with MCC with SLN metastasis from a prospective database, 137 treated with CLND and 26 treated with RT, were analyzed for outcomes.
  • Funding: National Cancer Institute.

Limitations

  • Retrospective study.
  • Small number of patients in RT group.
  • Short median follow-up (1.9 years).