The essential role of radiotherapy in the treatment of Merkel cell carcinoma: A study from the rare cancer network

Pirus Ghadjar, Johannes H. Kaanders, Philipp Poortmans, Renata Zaucha, Marco Krengli, Jean L. Lagrange, Orhan Özsoy, Tan D. Nguyen, Raymond Miralbell, Adele Baize, Noureddine Boujelbene, Timothy Collen, Luciano Scandolaro, Michel Untereiner, Hadassah Goldberg, Gianfranco A. Pesce, Yavuz Anacak, Esther E. Friedrich, Daniel M. Aebersold, Karl T. Beer

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57 Scopus citations

Abstract

Purpose: To evaluate the role of postoperative radiotherapy (RT) in Merkel cell carcinoma (MCC). Methods and Materials: A retrospective multicenter study was performed in 180 patients with MCC treated between February 1988 and September 2009. Patients who had had surgery alone were compared with patients who received surgery and postoperative RT or radical RT. Local relapse-free survival (LRFS), regional relapse-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were assessed together with disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates. Results: Seventy-nine patients were male and 101 patients were female, and the median age was 73 years old (range, 38-93 years). The majority of patients had localized disease (n = 146), and the remaining patients had regional lymph node metastasis (n = 34). Forty-nine patients underwent surgery for the primary tumor without postoperative RT to the primary site; the other 131 patients received surgery for the primary tumor, followed by postoperative RT (n = 118) or a biopsy of the primary tumor followed by radical RT (n = 13). Median follow-up was 5 years (range, 0.2-16.5 years). Patients in the RT group had improved LRFS (93% vs. 64%; p < 0.001), RRFS (76% vs. 27%; p < 0.001), DMFS (70% vs. 42%; p = 0.01), DFS (59% vs. 4%; p < 0.001), and CSS (65% vs. 49%; p = 0.03) rates compared to patients who underwent surgery for the primary tumor alone; LRFS, RRFS, DMFS, and DFS rates remained significant with multivariable Cox regression analysis. However OS was not significantly improved by postoperative RT (56% vs. 46%; p = 0.2). Conclusions: After multivariable analysis, postoperative RT was associated with improved outcome and seems to be an important component in the multimodality treatment of MCC.

Original languageEnglish
Pages (from-to)e583-e591
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number4
DOIs
StatePublished - 15 Nov 2011
Externally publishedYes

Keywords

  • Merkel cell carcinoma
  • Postoperative
  • Radiotherapy
  • Recurrence
  • Survival

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