Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma
Background The effects of primary tumor size on nodal involvement and of number of involved nodes on survival have not, to our knowledge, been examined in a national database of Merkel cell carcinoma (MCC). Objective We sought to analyze a retrospective cohort of patients with MCC from the largest U...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2014-04, Vol.70 (4), p.637-643 |
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| creator | Iyer, Jayasri G., MD Storer, Barry E., PhD Paulson, Kelly G., MD, PhD Lemos, Bianca, MD Phillips, Jerri Linn, MA, CTR Bichakjian, Christopher K., MD Zeitouni, Nathalie, MD Gershenwald, Jeffrey E., MD Sondak, Vernon, MD Otley, Clark C., MD Yu, Siegrid S., MD Johnson, Timothy M., MD Liegeois, Nanette J., MD Byrd, David, MD Sober, Arthur, MD Nghiem, Paul, MD, PhD |
| description | Background The effects of primary tumor size on nodal involvement and of number of involved nodes on survival have not, to our knowledge, been examined in a national database of Merkel cell carcinoma (MCC). Objective We sought to analyze a retrospective cohort of patients with MCC from the largest US national database to assess the relationships between these clinical parameters and survival. Methods A total of 8044 MCC cases in the National Cancer Data Base were analyzed. Results 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 number of involved nodes was strongly predictive of survival (0 nodes, 76% 5-year relative survival; 1 node, 50%; 2 nodes, 47%; 3-5 nodes, 42%; and ≥6 nodes, 24%; P < .0001 for trend). Younger and/or male patients were more likely to undergo pathological nodal evaluation. Limitations The National Cancer Data Base does not capture disease-specific survival. Hence, relative survival was calculated by comparing overall survival with age- and sex-matched US population data. Conclusion Pathologic nodal evaluation should be considered even for patients with small primary MCC tumors. The number of involved nodes is strongly predictive of survival and may help improve prognostic accuracy and management. |
| doi_str_mv | 10.1016/j.jaad.2013.11.031 |
| format | Article |
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Objective We sought to analyze a retrospective cohort of patients with MCC from the largest US national database to assess the relationships between these clinical parameters and survival. Methods A total of 8044 MCC cases in the National Cancer Data Base were analyzed. Results 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 number of involved nodes was strongly predictive of survival (0 nodes, 76% 5-year relative survival; 1 node, 50%; 2 nodes, 47%; 3-5 nodes, 42%; and ≥6 nodes, 24%; P < .0001 for trend). Younger and/or male patients were more likely to undergo pathological nodal evaluation. Limitations The National Cancer Data Base does not capture disease-specific survival. Hence, relative survival was calculated by comparing overall survival with age- and sex-matched US population data. Conclusion Pathologic nodal evaluation should be considered even for patients with small primary MCC tumors. The number of involved nodes is strongly predictive of survival and may help improve prognostic accuracy and management.</description><identifier>ISSN: 0190-9622</identifier><identifier>EISSN: 1097-6787</identifier><identifier>DOI: 10.1016/j.jaad.2013.11.031</identifier><identifier>PMID: 24521828</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; average tumor size ; Carcinoma, Merkel Cell - mortality ; Carcinoma, Merkel Cell - pathology ; Carcinoma, Merkel Cell - surgery ; Cohort Studies ; Databases, Factual ; Dermatology ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes - pathology ; Lymphatic Metastasis - pathology ; Male ; Merkel cell carcinoma ; Middle Aged ; National Cancer Data Base ; Neoplasm Invasiveness - pathology ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - parasitology ; Neoplasm Staging ; neuroendocrine carcinoma of the skin ; nodal spread ; Predictive Value of Tests ; Prognosis ; regional node metastasis ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Skin Neoplasms - mortality ; Skin Neoplasms - pathology ; Skin Neoplasms - surgery ; Survival Analysis ; Tumor Burden ; United States</subject><ispartof>Journal of the American Academy of Dermatology, 2014-04, Vol.70 (4), p.637-643</ispartof><rights>American Academy of Dermatology, Inc.</rights><rights>2013 American Academy of Dermatology, Inc.</rights><rights>Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-af79136bfbdd26fad45b99e0726086fccadf3113513735922a37f7e766b91c023</citedby><cites>FETCH-LOGICAL-c455t-af79136bfbdd26fad45b99e0726086fccadf3113513735922a37f7e766b91c023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0190962213012899$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24521828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iyer, Jayasri G., MD</creatorcontrib><creatorcontrib>Storer, Barry E., PhD</creatorcontrib><creatorcontrib>Paulson, Kelly G., MD, PhD</creatorcontrib><creatorcontrib>Lemos, Bianca, MD</creatorcontrib><creatorcontrib>Phillips, Jerri Linn, MA, CTR</creatorcontrib><creatorcontrib>Bichakjian, Christopher K., MD</creatorcontrib><creatorcontrib>Zeitouni, Nathalie, MD</creatorcontrib><creatorcontrib>Gershenwald, Jeffrey E., MD</creatorcontrib><creatorcontrib>Sondak, Vernon, MD</creatorcontrib><creatorcontrib>Otley, Clark C., MD</creatorcontrib><creatorcontrib>Yu, Siegrid S., MD</creatorcontrib><creatorcontrib>Johnson, Timothy M., MD</creatorcontrib><creatorcontrib>Liegeois, Nanette J., MD</creatorcontrib><creatorcontrib>Byrd, David, MD</creatorcontrib><creatorcontrib>Sober, Arthur, MD</creatorcontrib><creatorcontrib>Nghiem, Paul, MD, PhD</creatorcontrib><title>Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma</title><title>Journal of the American Academy of Dermatology</title><addtitle>J Am Acad Dermatol</addtitle><description>Background The effects of primary tumor size on nodal involvement and of number of involved nodes on survival have not, to our knowledge, been examined in a national database of Merkel cell carcinoma (MCC). Objective We sought to analyze a retrospective cohort of patients with MCC from the largest US national database to assess the relationships between these clinical parameters and survival. Methods A total of 8044 MCC cases in the National Cancer Data Base were analyzed. Results 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 number of involved nodes was strongly predictive of survival (0 nodes, 76% 5-year relative survival; 1 node, 50%; 2 nodes, 47%; 3-5 nodes, 42%; and ≥6 nodes, 24%; P < .0001 for trend). Younger and/or male patients were more likely to undergo pathological nodal evaluation. Limitations The National Cancer Data Base does not capture disease-specific survival. Hence, relative survival was calculated by comparing overall survival with age- and sex-matched US population data. Conclusion Pathologic nodal evaluation should be considered even for patients with small primary MCC tumors. The number of involved nodes is strongly predictive of survival and may help improve prognostic accuracy and management.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>average tumor size</subject><subject>Carcinoma, Merkel Cell - mortality</subject><subject>Carcinoma, Merkel Cell - pathology</subject><subject>Carcinoma, Merkel Cell - surgery</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Dermatology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Merkel cell carcinoma</subject><subject>Middle Aged</subject><subject>National Cancer Data Base</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - parasitology</subject><subject>Neoplasm Staging</subject><subject>neuroendocrine carcinoma of the skin</subject><subject>nodal spread</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>regional node metastasis</subject><subject>Retrospective Studies</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Skin Neoplasms - mortality</subject><subject>Skin Neoplasms - pathology</subject><subject>Skin Neoplasms - surgery</subject><subject>Survival Analysis</subject><subject>Tumor Burden</subject><subject>United States</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcuO1DAQRS0EYpqBH2CBvGQxCS47iWMJIaERL2kQEo-15dgVcE9iN3YSMXwN38KXkdANCxZsXJtzr8qnCHkIrAQGzZN9uTfGlZyBKAFKJuAW2QFTsmhkK2-THQPFCtVwfkbu5bxnjKlKyLvkjFc1h5a3O_LtPQ5m8jHkL_6QqRlj-EwPyY8m3dBpHmOi2X_HCxrmscNEY__zhw9LHBZ0NESH-YKa4Gie0-IXM9B-TbSsqqg1GfNv_i2maxyoxWF9TLI-xNHcJ3d6M2R8cJrn5NPLFx8vXxdX7169uXx-VdiqrqfC9FKBaLq-c443vXFV3SmFTPKGtU1vrXG9ABA1CClqxbkRspcom6ZTYBkX5-TxsfeQ4tcZ86RHn7dVTMA4Zw01aysOULUryo-oTTHnhL0-idDA9GZc7_VmXG_GNYBeja-hR6f-uRvR_Y38UbwCT48Arr9cPCadrcdg0fmEdtIu-v_3P_snbgcfvDXDNd5g3sc5hdWfBp25ZvrDdvPt5CAY8FYp8QtzQ6ih</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Iyer, Jayasri G., MD</creator><creator>Storer, Barry E., PhD</creator><creator>Paulson, Kelly G., MD, PhD</creator><creator>Lemos, Bianca, MD</creator><creator>Phillips, Jerri Linn, MA, CTR</creator><creator>Bichakjian, Christopher K., MD</creator><creator>Zeitouni, Nathalie, MD</creator><creator>Gershenwald, Jeffrey E., MD</creator><creator>Sondak, Vernon, MD</creator><creator>Otley, Clark C., MD</creator><creator>Yu, Siegrid S., MD</creator><creator>Johnson, Timothy M., MD</creator><creator>Liegeois, Nanette J., MD</creator><creator>Byrd, David, MD</creator><creator>Sober, Arthur, MD</creator><creator>Nghiem, Paul, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma</title><author>Iyer, Jayasri G., MD ; Storer, Barry E., PhD ; Paulson, Kelly G., MD, PhD ; Lemos, Bianca, MD ; Phillips, Jerri Linn, MA, CTR ; Bichakjian, Christopher K., MD ; Zeitouni, Nathalie, MD ; Gershenwald, Jeffrey E., MD ; Sondak, Vernon, MD ; Otley, Clark C., MD ; Yu, Siegrid S., MD ; Johnson, Timothy M., MD ; Liegeois, Nanette J., MD ; Byrd, David, MD ; Sober, Arthur, MD ; Nghiem, Paul, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-af79136bfbdd26fad45b99e0726086fccadf3113513735922a37f7e766b91c023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>average tumor size</topic><topic>Carcinoma, Merkel Cell - mortality</topic><topic>Carcinoma, Merkel Cell - pathology</topic><topic>Carcinoma, Merkel Cell - surgery</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Dermatology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Merkel cell carcinoma</topic><topic>Middle Aged</topic><topic>National Cancer Data Base</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - parasitology</topic><topic>Neoplasm Staging</topic><topic>neuroendocrine carcinoma of the skin</topic><topic>nodal spread</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>regional node metastasis</topic><topic>Retrospective Studies</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Skin Neoplasms - mortality</topic><topic>Skin Neoplasms - pathology</topic><topic>Skin Neoplasms - surgery</topic><topic>Survival Analysis</topic><topic>Tumor Burden</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iyer, Jayasri G., MD</creatorcontrib><creatorcontrib>Storer, Barry E., PhD</creatorcontrib><creatorcontrib>Paulson, Kelly G., MD, PhD</creatorcontrib><creatorcontrib>Lemos, Bianca, MD</creatorcontrib><creatorcontrib>Phillips, Jerri Linn, MA, CTR</creatorcontrib><creatorcontrib>Bichakjian, Christopher K., MD</creatorcontrib><creatorcontrib>Zeitouni, Nathalie, MD</creatorcontrib><creatorcontrib>Gershenwald, Jeffrey E., MD</creatorcontrib><creatorcontrib>Sondak, Vernon, MD</creatorcontrib><creatorcontrib>Otley, Clark C., MD</creatorcontrib><creatorcontrib>Yu, Siegrid S., MD</creatorcontrib><creatorcontrib>Johnson, Timothy M., MD</creatorcontrib><creatorcontrib>Liegeois, Nanette J., MD</creatorcontrib><creatorcontrib>Byrd, David, MD</creatorcontrib><creatorcontrib>Sober, Arthur, MD</creatorcontrib><creatorcontrib>Nghiem, Paul, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iyer, Jayasri G., MD</au><au>Storer, Barry E., PhD</au><au>Paulson, Kelly G., MD, PhD</au><au>Lemos, Bianca, MD</au><au>Phillips, Jerri Linn, MA, CTR</au><au>Bichakjian, Christopher K., MD</au><au>Zeitouni, Nathalie, MD</au><au>Gershenwald, Jeffrey E., MD</au><au>Sondak, Vernon, MD</au><au>Otley, Clark C., MD</au><au>Yu, Siegrid S., MD</au><au>Johnson, Timothy M., MD</au><au>Liegeois, Nanette J., MD</au><au>Byrd, David, MD</au><au>Sober, Arthur, MD</au><au>Nghiem, Paul, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma</atitle><jtitle>Journal of the American Academy of Dermatology</jtitle><addtitle>J Am Acad Dermatol</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>70</volume><issue>4</issue><spage>637</spage><epage>643</epage><pages>637-643</pages><issn>0190-9622</issn><eissn>1097-6787</eissn><abstract>Background The effects of primary tumor size on nodal involvement and of number of involved nodes on survival have not, to our knowledge, been examined in a national database of Merkel cell carcinoma (MCC). Objective We sought to analyze a retrospective cohort of patients with MCC from the largest US national database to assess the relationships between these clinical parameters and survival. Methods A total of 8044 MCC cases in the National Cancer Data Base were analyzed. Results 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 number of involved nodes was strongly predictive of survival (0 nodes, 76% 5-year relative survival; 1 node, 50%; 2 nodes, 47%; 3-5 nodes, 42%; and ≥6 nodes, 24%; P < .0001 for trend). Younger and/or male patients were more likely to undergo pathological nodal evaluation. Limitations The National Cancer Data Base does not capture disease-specific survival. Hence, relative survival was calculated by comparing overall survival with age- and sex-matched US population data. Conclusion Pathologic nodal evaluation should be considered even for patients with small primary MCC tumors. The number of involved nodes is strongly predictive of survival and may help improve prognostic accuracy and management.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24521828</pmid><doi>10.1016/j.jaad.2013.11.031</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over average tumor size Carcinoma, Merkel Cell - mortality Carcinoma, Merkel Cell - pathology Carcinoma, Merkel Cell - surgery Cohort Studies Databases, Factual Dermatology Disease-Free Survival Female Humans Lymph Nodes - pathology Lymphatic Metastasis - pathology Male Merkel cell carcinoma Middle Aged National Cancer Data Base Neoplasm Invasiveness - pathology Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - parasitology Neoplasm Staging neuroendocrine carcinoma of the skin nodal spread Predictive Value of Tests Prognosis regional node metastasis Retrospective Studies Sentinel Lymph Node Biopsy Skin Neoplasms - mortality Skin Neoplasms - pathology Skin Neoplasms - surgery Survival Analysis Tumor Burden United States |
| title | Relationships among primary tumor size, number of involved nodes, and survival for 8044 cases of Merkel cell carcinoma |
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