Abstract: Adjuvant Radiation Therapy Correlates with Increased Disease Free Survival In Stage I Merkel Cell Carcinoma (Plastic Surgery 2011 (September 23-27, 2011))

Saturday, September 24, 2011: 1:40 PM

Colorado Convention Center

Stephen Poteet, MD , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

Kevin Sexton, MD , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

Alexander Schmidt, MS , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

Ashit Patel, MD , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

Michael Osgood, MD , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

Mark Kelley, MD , Department of Surgery, Division of Surgical Oncology, Vanderbilt University, Nashville, TN

R. Bruce Shack, MD , Department of Plastic Surgery, Vanderbilt Medical Center, Nashville, TN

-The concise purpose:

Merkel Cell Carcinoma is a rare and aggressive neuroendocrine malignancy of the skin.

This study seeks to determine the prognostic value of adjuvant radiation therapy in

relation to disease-free survival among patients treated surgically for Merkel Cell

Carcinoma.

-The methods and materials used:

The Vanderbilt Melanoma and Cutaneous Malignancy Data Repository was searched for

patients treated for Merkel Cell Carcinoma. Data was collected regarding demographics

medical comorbidities, tumor stage, and treatment for patients diagnosed with Merkel

Cell Carcinoma from 1998 to 2010.

-Experience including number of cases and follow-up:

A total of 27 cases were identified. The mean follow-up period was 32.9 months (range,

1-143 months). No statistical difference was observed regarding follow-up between

patients receiving adjuvant radiation and those receiving excision only (p = 0.37). Mean

follow-up for stage I patients who received adjuvant radiation was 29.1 months, and 22.4

months for those who received no radiation (p = 1.0).

-Summary of results:

The average age of the population was 70.8 years. Of those receiving adjuvant

radiation, the mean age was 66.1 years, compared to 74.6 years for those not receiving

radiation (p = 0.08). All patients received wide-local excision. Of the 27 patients, 3 were

diagnosed with metastatic disease and excluded from comparison. 10 patients received

adjuvant radiation therapy, of which 40% were stage I, 10% stage II, and 50% were

stage III. The remaining 14 patients received excision only. Of these, 78.5%

were stage I, while 21.5% were stage III. No recurrence was observed among the 4

patients receiving radiation therapy for stage I disease. However, of the 11 stage I

patients not receiving radiation therapy 4 recurred (36.3%).

-Reasonable and understandable conclusions:

These results suggest that stage I Merkel Cell Carcinoma should be treated with

wide-local excision and adjuvant radiation therapy. Given the small sample size

further studies are needed to validate this conclusion, however, our data suggests

that early stage Merkel Cell should be treated with XRT to reduce rate of recurrence.

18953 Adjuvant Radiation Therapy Correlates with Increased Disease Free Survival In Stage I Merkel Cell Carcinoma