scholarly journals Merkel Cell Carcinoma: Evaluation of the Clinico-Pathological Characteristics, Treatment Strategies and Prognostic Factors in a Monocentric Retrospective Series (n=143)

2021 ◽  
Vol 11 ◽  
Author(s):  
Marco Rastrelli ◽  
Paolo Del Fiore ◽  
Irene Russo ◽  
Jacopo Tartaglia ◽  
Alessandro Dal Monico ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Regional Lymph Node ◽  
Treatment Strategies ◽  
University Hospital ◽  
Merkel Cell ◽  
Pathological Characteristics ◽  
Negative Prognostic Factor

BackgroundMerkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. The incidence of the disease has undergone a significant increase in recent years, which is caused by an increase in the average age of the population and in the use of immunosuppressive therapies. MCC is an aggressive pathology, which metastasizes early to the lymph nodes. These characteristics impose an accurate diagnostic analysis of the regional lymph node district with radiography, clinical examination and sentinel node biopsy. In recent years, there has been a breakthrough in the treatment of the advanced pathology thanks to the introduction of monoclonal antibodies acting on the PD-1/PD-L1 axis. This study aimed to describe the clinico-pathological characteristics, treatment strategies and prognostic factors of MCC.MethodsA retrospective cohort study was conducted involving 143 consecutive patients who were diagnosed and/or treated for MCC. These patients were referred to the Veneto Institute of Oncology IOV-IRCCS and to the University Hospital of Padua (a third-level center) in the period between December 1991 and January 2020. In the majority of cases, diagnosis took place at the IOV. However, some patients were diagnosed elsewhere and subsequently referred to the IOV for a review of the diagnosis or to begin specific therapeutic regimens.Results143 patients, with an average age of 71 years, were affected mainly with autoimmune and neoplastic comorbidities. Our analysis has shown that age, autoimmune comorbidities and the use of therapy with immunomodulating drugs (which include corticosteroids, statins and beta-blockers) are associated with a negative prognosis. In this sense, male sex is also a negative prognostic factor.ConclusionsAutoimmune and neoplastic comorbidities were frequent in the studied population. The use of drugs with immunomodulatory effects was also found to be a common feature of the population under examination. The use of this type of medication is considered a negative prognostic factor. The relevance of a multidisciplinary approach to the patient with MCC is confirmed, with the aim of assessing the risks and benefits related to the use of immunomodulating therapy in the individual patient.

Frequency and prognosis of metastasis to liver, lung, bone and brain from Merkel cell carcinoma

2020 ◽  
Vol 16 (16) ◽  
pp. 1101-1113 ◽  
Author(s):  
Yi-Jun Xia ◽  
Dong-Sheng Cao ◽  
Jun Zhao ◽  
Bang-Zhong Zhu ◽  
Juan Xie
Keyword(s):  
Lymph Node ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Distant Metastasis ◽  
Regional Lymph Node ◽  
Distant Metastases ◽  
Lymph Node Biopsy ◽  
Merkel Cell ◽  
Factors Affecting ◽  
Node Removal

Aim: To describe the factors affecting distant metastasis of Merkel cell carcinoma (MCC) and the prognosis of metastatic MCC. Materials & methods: The MCC patient information was downloaded from the SEER database. Logistic regression and Cox proportional hazard models were conducted to screen for significant factors. Results: A total of 3449 patients were enrolled. Surgery and chemotherapy were significantly correlated with the occurrence of distant metastasis. In the cause-specific survival rate of MCC, regional lymph node removal, sentinel lymph node biopsy, radiation and chemotherapy can significantly reduce the prognostic risk of patients with distant metastases. Conclusion: Our study screened out the factors affecting the distant metastasis and prognosis of MCC and more prospective studies are needed to verify our findings.

scholarly journals Analysis of Prognostic Factors from 9387 Merkel Cell Carcinoma Cases Forms the Basis for the New 8th Edition AJCC Staging System

2016 ◽  
Vol 23 (11) ◽  
pp. 3564-3571 ◽  
Author(s):  
Kelly L. Harms ◽  
Mark A. Healy ◽  
Paul Nghiem ◽  
Arthur J. Sober ◽  
Timothy M. Johnson ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Staging System ◽  
Merkel Cell ◽  
Ajcc Staging System ◽  
Ajcc Staging ◽  
8Th Edition

scholarly journals Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Farees Saqlain ◽  
Sophia Z. Shalhout ◽  
Kevin S. Emerick ◽  
Tomas G. Neilan ◽  
Tatyana Sharova ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Regional Lymph Node ◽  
Lymph Node Involvement ◽  
High Rate ◽  
Merkel Cell ◽  
Node Involvement ◽  
Cutaneous Neuroendocrine Carcinoma ◽  
Cutaneous Adverse Event

Merkel cell carcinoma is a rare cutaneous neuroendocrine carcinoma with a high rate of regional and distant metastasis and mortality. Here, we report a novel case of Merkel cell carcinoma which presented as a primary lesion to the left cheek with regional lymph node involvement and was treated with pembrolizumab and radiation. Widely metastatic disease eventually revealed on autopsy clinically mimicked immune-related organ insult leading to management with immunosuppressants. The patient also had a biopsy-confirmed immune-related cutaneous adverse event during admission. The case highlights a rare circumstance in which disease progression masqueraded as multiple immune-related end-organ adverse events. Contribution of on-target anti-PD-1 toxicity remains a possibility.

scholarly journals Features Predicting Sentinel Lymph Node Positivity in Merkel Cell Carcinoma

2011 ◽  
Vol 29 (8) ◽  
pp. 1036-1041 ◽  
Author(s):  
Jennifer L. Schwartz ◽  
Kent A. Griffith ◽  
Lori Lowe ◽  
Sandra L. Wong ◽  
Scott A. McLean ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Growth Pattern ◽  
Regional Lymph Node ◽  
Mitotic Rate ◽  
Tumor Thickness ◽  
Merkel Cell ◽  
Primary Tumors

Purpose Merkel cell carcinoma (MCC) is a relatively rare, potentially aggressive cutaneous malignancy. We examined the clinical and histologic features of primary MCC that may correlate with the probability of a positive sentinel lymph node (SLN). Methods Ninety-five patients with MCC who underwent SLN biopsy at the University of Michigan were identified. SLN biopsy was performed on 97 primary tumors, and an SLN was identified in 93 instances. These were reviewed for clinical and histologic features and associated SLN positivity. Univariate associations between these characteristics and a positive SLN were tested for by using either the χ2 or the Fisher's exact test. A backward elimination algorithm was used to help create a best multiple variable model to explain a positive SLN. Results SLN positivity was significantly associated with the clinical size of the lesion, greatest horizontal histologic dimension, tumor thickness, mitotic rate, and histologic growth pattern. Two competing multivariate models were generated to predict a positive SLN. The histologic growth pattern was present in both models and combined with either tumor thickness or mitotic rate. Conclusion Increasing clinical size, increasing tumor thickness, increasing mitotic rate, and infiltrative tumor growth pattern were significantly associated with a greater likelihood of a positive SLN. By using the growth pattern and tumor thickness model, no subgroup of patients was predicted to have a lower than 15% to 20% likelihood of a positive SLN. This suggests that all patients presenting with MCC without clinical evidence of regional lymph node disease should be considered for SLN biopsy.

Absolute Lymphocyte Count as a Prognostic Factor for Merkel Cell Carcinoma

2012 ◽  
Vol 84 (3) ◽  
pp. S136-S137
Author(s):  
M.E. Johnson ◽  
A. Turaka ◽  
F. Zhu ◽  
T. Galloway ◽  
J. Farma ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Merkel Cell

Prognostic factors in Merkel cell carcinoma patients undergoing sentinel node biopsy

2017 ◽  
Vol 43 (8) ◽  
pp. 1536-1541 ◽  
Author(s):  
I. Mattavelli ◽  
R. Patuzzo ◽  
V. Torri ◽  
G. Gallino ◽  
A. Maurichi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Sentinel Node ◽  
Cell Carcinoma ◽  
Sentinel Node Biopsy ◽  
Merkel Cell Carcinoma ◽  
Merkel Cell ◽  
Node Biopsy

scholarly journals Immunotherapy with imiquimod and interferon alfa for metastasized Merkel cell carcinoma

2016 ◽  
Vol 23 (2) ◽  
pp. 150 ◽  
Author(s):  
R.U. Wahl ◽  
T. Braunschweig ◽  
A. Ghassemi ◽  
A. Rübben
Keyword(s):  
Lymph Node ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Lymph Node Metastases ◽  
Neuroendocrine Tumour ◽  
Regional Lymph Node ◽  
Pegylated Interferon ◽  
Interferon Alfa ◽  
Merkel Cell ◽  
Node Metastases

Merkel cell carcinoma (mcc) is a highly aggressive neuroendocrine tumour of the skin. Remission rates are high with chemotherapy in patients with metastasis, but without any improvement in overall survival.We present the case of a 90-year-old woman with facial mcc. After radiation and surgery, the mcc recurred with widespread cutaneous and regional lymph node metastases. The metastases were treated with weekly intralesional injections of 1–2×106 IU interferon alfa-2a, accompanied by topical imiquimod 5% cream 3 times weekly. After partial regression, subcutaneous pegylated interferon alfa-2b was added at a dose of 30 μg weekly, which was then increased to 50 μg weekly. At 4 months after the start of immunotherapy, all cutaneous metastases and the intralesionally treated lymph node metastases receded. Interruption or reduction of systemic interferon application resulted in locoregional relapses that were successfully treated with surgery or intralesional interferon injections. The patient remains alive 30 months after initiation of immunotherapy, suggesting that locally metastasized mcc might be able to be controlled with local and systemic immunotherapy.

Updated Review of the Pathogenesis and Management of Merkel Cell Carcinoma

2010 ◽  
Vol 14 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Anna Zampetti ◽  
Claudio Feliciani ◽  
Guido Massi ◽  
Antonello Tulli
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Regional Lymph Node ◽  
Surgical Excision ◽  
The Elderly ◽  
The Body ◽  
Merkel Cell ◽  
Mesh Terms ◽  
Standardized Treatment ◽  
Localized Disease

Background:Merkel cell carcinoma is a rare, aggressive, malignant cutaneous tumor of the elderly or immunosuppressed individuals that usually appears on sun-exposed areas of the body. Its pathogenesis is still debated, and, currently, no standardized treatment exists.Objective:To provide a current updated review of the most relevant data concerning the pathogenesis and management of Merkel cell carcinoma.Methods:Using relevant MeSH terms, we performed a review of the literature on these subjects from 1980 to June 2009.Results and Conclusion:The current management of Merkel cell carcinoma is based on surgical excision as the majority of patients present with localized disease, whereas up to 30% have regional lymph node metastases. In these cases, the best outcome is achieved with multidisciplinary management that includes radiotherapy. Chemotherapy is part of the treatment in advanced cases and is mandatory for distant metastatis. Given that a recent work showed the presence of a previously unknown polyomavirus, which the authors called Merkel cell polyomavirus, the therapeutical approach to Merkel cell carcinoma could be reconsidered in the future.

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