Annals of Surgical Oncology

, Volume 15, Issue 9, pp 2509–2518 | Cite as

Management of Merkel Cell Carcinoma: The Roles of Lymphoscintigraphy, Sentinel Lymph Node Biopsy and Adjuvant Radiotherapy

  • Ross E. Warner
  • Michael J. Quinn
  • George Hruby
  • Richard A. Scolyer
  • Roger F. Uren
  • John F. Thompson
Bone and Soft Tissue Sarcomas

Abstract

Background

Merkel cell carcinoma (MCC) is an uncommon, highly aggressive skin malignancy with a propensity to recur locally and regionally. However, its optimal treatment is uncertain. In this study, we aimed to assess the roles of lymphoscintigraphy and sentinel node (SN) biopsy, as well as radiotherapy, in the treatment of MCC.

Patients and Methods

A retrospective analysis of 17 patients diagnosed with MCC (median age 74 years) over a 7-year period (median follow-up 16 months) was performed.

Results

Of 11 patients. 3 had a positive SN biopsy and, despite adjuvant radiotherapy, 2 of these 3 developed regional lymph node (RLN) recurrence. Of the remaining 8 patients who had a negative SN biopsy, however, 5 also had RLN recurrences. There were 9 patients who received adjuvant radiotherapy (RT) to the primary site, with no in-field recurrences; and 8 who received RT to their RLN field, with only 2 developing regional nodal recurrences—both were SN biopsy positive. During the follow-up period, 2 patients died, only 1 due to MCC.

Conclusion

The results suggest that SN status may not be an accurate predictor of loco-regional recurrence in MCC. However, they strongly reinforce previous reports that radiotherapy, both locally and to regional nodes, provides effective infield disease control.

Keywords

Merkel cell carcinoma Lymphoscintigraphy Prognosis Radiotherapy Sentinel lymph node biopsy Treatment 

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Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Ross E. Warner
    • 1
  • Michael J. Quinn
    • 1
  • George Hruby
    • 2
  • Richard A. Scolyer
    • 1
    • 3
    • 4
  • Roger F. Uren
    • 5
    • 6
  • John F. Thompson
    • 1
    • 7
  1. 1.Sydney Melanoma Unit, Sydney Cancer CentreRoyal Prince Alfred HospitalCamperdown, SydneyAustralia
  2. 2.Department of Radiation OncologyRoyal Prince Alfred HospitalCamperdown, SydneyAustralia
  3. 3.Department of Anatomical PathologyRoyal Prince Alfred HospitalCamperdown, SydneyAustralia
  4. 4.Discipline of PathologyThe University of SydneySydneyAustralia
  5. 5.Nuclear Medicine and Diagnostic UltrasoundRoyal Prince Alfred Hospital Medical CentreNewtownAustralia
  6. 6.Discipline of MedicineThe University of SydneySydneyAustralia
  7. 7.Discipline of SurgeryThe University of SydneySydneyAustralia

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