Oncology Medical News about Merkel Cell carcinoma tumors;lymph node metastasis

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Patients with Merkel cell carcinoma tumors ≤1.0 cm in diameter are unlikely to harbor regional lymph node metastasis
Journal of Clinical Oncology, 07/08/09

Stokes JB et al. - In a trial to determine whether a cohort of low-risk pts with Merkel cell carcinoma (MCC) may exist for whom regional nodal metastasis would be unlikely, it was found that pts with MCC ≤1.0 cm were unlikely to have regional lymph node metastasis, suggesting that regional nodal evaluation may reasonably be avoided in these pts. These data support sentinel lymph node biopsy (SLNB) for MCC >1 cm in diameter.

Methods

A retrospective review of the Department of Veterans Affairs national health care database was performed.
Pts undergoing resection of primary MCC were identified; and demographic, medical, and social history; tumor characteristics; nodal status; and recurrence events were recorded.

Results

346 pts were diagnosed with MCC.
213 of 346 underwent resection of the primary lesion and evaluation of the draining lymph node basin.
54 pts (25%) had tumors ≤1.0 cm in diameter.
Average tumor diameter was 0.7 cm, and 63% were located on the head or neck.
Only 2 pts (4%) with tumors ≤1.0 cm had regional lymph node metastasis vs 51 (24%) of 213 pts with tumors >1.0 cm.
Both pts had clinically evident nodal disease at presentation and underwent CLND.
Both have remained recurrence-free for 40 mos.
13 (25%) of 51 pts with nodal metastasis and tumors >1 cm had occult nodal metastasis.

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