caa a22 4500 445333634 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1662-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1662-y Recurrence and Survival in Patients Undergoing Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma: Analysis of 153 Patients from a Single Institution [Elektronische Daten] [Ryan Fields, Klaus Busam, Joanne Chou, Katherine Panageas, Melissa Pulitzer, Dennis Kraus, Mary Brady, Daniel Coit] Background: Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine neoplasm with propensity for lymphatic spread. The rarity of MCC has limited analysis of factors associated with a positive sentinel lymph node biopsy (SLNB) and survival. Methods: Review of a prospective MCC database was performed. Factors associated with SLNB positivity were analyzed. Univariate and multivariate analyses of factors associated with recurrence and survival were performed using the cumulative incidence (CI) function, treating death from other causes as a competing risk. Results: From 1996 to 2010, a total of 153 patients with localized MCC underwent SLNB, of whom 45 (29%) were positive. Factors associated with SLNB positivity were primary tumor size (25% ≤2cm vs. 45% >2cm; P=0.02) and presence of lymphovascular invasion (LVI) (55% LVI positive vs. 4% LVI negative; P<0.01). SLNB-positive patients were more likely to receive radiation or chemotherapy (60% vs. 7%, P<0.01). With median follow-up of 41months, there were 16 nodal/distant recurrences (10%), 11 deaths from MCC (7%), and 27 death from other causes (18%). The 2-year CIs of recurrence or death from MCC were 12% and 6%, respectively. There was no difference in recurrence or death from MCC between SLNB-positive and -negative patients. The 2-year CIs of recurrence or death from MCC for LVI-positive patients were 30% and 15%, respectively. No LVI-negative patient experienced recurrence of disease or died of MCC. Discussion: SLNB identifies occult nodal metastases in 29% of patients with localized MCC. Predictors of SLNB positivity are tumor size and presence of lymphovascular invasion (LVI). Patients with SLNB-positive disease are more likely to receive further treatment; however, sentinel lymph node (SLN) status is not associated with recurrence or survival. In contrast, LVI is strongly associated with both recurrence and survival. Society of Surgical Oncology, 2011 Fields Ryan Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Busam Klaus Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Chou Joanne Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Panageas Katherine Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Pulitzer Melissa Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Kraus Dennis Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Brady Mary Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Coit Daniel Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2529-2537 1068-9265 18:9<2529 2011 18 10434 https://doi.org/10.1245/s10434-011-1662-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1662-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fields Ryan Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Busam Klaus Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Chou Joanne Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Panageas Katherine Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Pulitzer Melissa Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Kraus Dennis Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Brady Mary Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Coit Daniel Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2529-2537 1068-9265 18:9<2529 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer