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Soo Park, MD
Soo Park, MD
Posted: Thursday, January 20, 2022
Patients with Merkel cell carcinoma tend to be older, and they are primarily treated with postoperative radiotherapy; however, physicians often deviate from treatment protocols because patients may be too frail to withstand such therapy. In a report published in Radiotherapy & Oncology, Margot E.T. Tesselaar, MD, PhD, of the Netherlands Cancer Institute, Amsterdam, and colleagues suggest patient criteria for postoperative radiotherapy be further refined to include factors such as life expectancy.
“Trends in overall survival benefit are likely to be caused by selection bias, suggesting further refinement of criteria for postoperative radiotherapy is warranted,” the research team concluded.
The research team retrospectively evaluated the effects of postoperative radiotherapy on outcomes in 182 patients with Merkel cell carcinoma. Patients with pathologic (sentinel node–negative) stage I and II (n = 35), clinical (no sentinel node biopsy performed) stage I and II (n = 69), and stage III (n = 78) Merkel cell carcinoma were evaluated separately. The median durations of follow-up for each cohort were 53.5 months, 30.5 months, and 29.3 months, respectively.
Based on a multivariable analysis, postoperative radiotherapy was associated with less disease recurrence and improved overall survival in all patient groups; however, no improvement was reported in Merkel cell carcinoma–related survival. For patients with stage III disease, extracapsular extension (P = .012) and postoperative radiotherapy (P = .044) appeared to be significantly associated with disease recurrence. By contrast, stage III disease with at least four positive lymph nodes seemed to be associated with Merkel cell carcinoma–related survival (P = .024).
Disclosure: The study authors reported no conflicts of interest.
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