To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Radiation Plus Wide Excision Improves Survival in Patients with Merkel Cell Carcinoma: Presented at ASTRO URL: http://www.pslgroup.com/dg/2169B2.htm Doctor's Guide November 2, 2007
By Ed Susman LOS ANGELES, CA -- November 2, 2007 -- Long-term outcomes data indicate that use of radiation therapy and wide excisions offers the best chance for patients with Merkel cell carcinoma to survive for at least 5 years, say researchers. Overall, 39% of patients diagnosed with the relatively rare and difficult to treat neuroendocrine cancer of the skin survived 5 years and 31% of those patients achieved disease-free survival for 5 years. In the retrospective review of patients with Merkel cell, Larry Kestin, MD, Program Director, Radiation Oncology Residency, William Beaumont Hospitals, Royal Oak, Michigan, United States, and his colleagues identified 51 patients who were treated for the malignancy. About 95% of the patients underwent surgery with wide local excision with and without lymph node dissection. The remaining 5% only were treated through biopsy. About 76% of the patients underwent surgical assessment of the regional lymph nodes -- 44% of whom had traditional dissection and 56% of who were guided though sentinel lymph node biopsy. "We reviewed our experience treating Merkel cell carcinoma with combined modality therapy and sentinel lymph node biopsy," said Dr. Kestin in a poster presentation October 30 at the 49th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). "Postoperative radiotherapy and complete surgical excision with negative margins are associated with improved survival for Merkel cell cancer," he explained. Thirty one patients -- 61% of the group - received adjuvant post-operative radiotherapy, to a median dose of 50 Gray in 1.8 to 2.0 Gray fractions. About half the patients had the tumour bed irradiated; the others had both the surgical bed and the lymph nodes irradiated. The researchers found that 44% of patients treated with both surgery and radiation achieved 5-year disease free survival compared with 14% of patients who did not undergo radiation therapy (P =.05). About 56% of these patients survived 5 years compared with 21% of the patients who did not receive radiation, a difference that did not meet statistical significance (P =.11). About 43% of patients were treated with chemotherapy -- platinum-based adjuvant regimens. Overall, 39% of patients who did not receive chemotherapy had disease-free survival compared with 24% of patients who did receive platinum drugs (P=.24). Overall survival was 61% among patients not receiving chemotherapy compared with 24% of those receiving the platinum-based regimens. "No subgroup was identified that benefited from chemotherapy," Dr. Kestin said, "although patients receiving chemotherapy generally had multiple worse prognostic factors." About 41% of patients with negative surgical margins achieved 5-year disease free survival compared with 22% of patients who had positive surgical margins (P <.01). Similarly, 54% of patients with negative margins survived 5 years compared with 22% of patients with positive margins (P <.01), Dr. Kestin said. According to the United States National Cancer Institute, Merkel cell carcinoma is a rare type of disease in which malignant cells are found on or just beneath the skin and in hair follicles. Merkel cell carcinoma usually appears as firm, painless, shiny lumps of skin on the sun-exposed areas of the head, neck, arms, and legs. [Presentation title: Improved Survival With Negative Margins and Post-operative Radiotherapy for Merkel Cell Carcinoma. Abstract 2982] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.