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Merkel cell carcinoma tumors posed risk for nodal involvement regardless of size
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Patients with small Merkel cell carcinoma tumors had a significant risk for nodal involvement, with less nodes predictive of longer survival, according to recent study results.
Researchers analyzed 8,044 Merkel cell carcinoma (MCC) cases (61% men) in the National Cancer Data Base to assess the relationship between primary tumor size on nodal involvement and the number of nodes on survival.
“There was a 14% risk of regional nodal involvement for 0.5-cm tumors that increased to 25% for 1.7-cm (median-sized) tumors and to more than 36% for tumors 6 cm or larger,” the researchers reported. Larger lesions accounted for less than 1% of lesions.
Five-year relative survival was strongly predicted by the number of involved nodes (76%, no nodes; one node, 50%; two nodes, 47%; three to five nodes, 42%; and six or more nodes, 24%; P<.0001 for trend). Pathological nodal evaluation was more often performed for younger and/or male patients (P<.0001).
“The findings … demonstrate that there is no primary tumor size for which the risk of nodal involvement is clinically negligible,” the researchers concluded. “Even patients with small [MCCs] should be counseled about possible nodal involvement and those with more than one involved node should be followed particularly closely.
“This study also demonstrates that the number of involved nodes is strongly predictive of survival and thus may be relevant for clinical management and potentially useful in future MCC staging systems.”
Disclosure: The researchers report no relevant financial disclosures.
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