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