This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mojica, P. Articles by Ellenhorn, J. D.I. Search for Related Content PubMed PubMed Citation Articles by Mojica, P. Articles by Ellenhorn, J. D.I. Related Articles Related Correspondence

Adjuvant Radiation Therapy Is Associated With Improved Survival in Merkel Cell Carcinoma of the Skin

Pablo Mojica, David Smith, Joshua D.I. Ellenhorn

From the Divisions of Surgery and Information Sciences City of Hope National Medical Center, Duarte, CA

Address reprint requests to Joshua D.I. Ellenhorn, MD, City of Hope National Medical Center, 1500 East Duarte Rd, Duarte, CA 91010; e-mail: jellenhorn{at}coh.org

Purpose: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy. Because of the absence of randomized studies, the real benefit of adjuvant radiation therapy in MCC is unclear. The aim of this study was to better define the role of adjuvant radiation therapy in the management of MCC.

Methods: The Surveillance, Epidemiology, and End Results (SEER) survey from the National Cancer Institute was queried from 1973 through 2002. Retrospective analysis was performed. The end point of the study was overall survival.

Results: There were 1,665 cases of MCC in the SEER registry. Presentation by stage were 55% stage I, 31% stage II, and 6% stage III. Eight percent of the cases could not be staged because of incomplete data. Surgical intervention was a component of therapy in 89% of the cases (n = 1,487). The median survival for the entire cohort was 49 months, and median follow-up was 40 months. Adjuvant radiation was a component of therapy in 40% of the surgical cases. The median survival for those patients receiving adjuvant radiation therapy was 63 months compared with 45 months for those treated without adjuvant radiation. The use of radiation was associated with an improved survival for patients with all sizes of tumors, but the improvement with radiation use was particularly prominent when analyzing those patients with primary lesions larger than 2 cm.

Conclusion: The use of adjuvant radiation therapy is associated with improved survival in patients with MCC. Prospective evaluation of adjuvant radiation therapy in this setting is warranted.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Related Correspondence

• Regarding Adjuvant Radiation Therapy in Merkel Cell Carcinoma: Selection Bias and Its Affect on Overall Survival
  Douglas M. Housman, Roy H. Decker, and Lynn D. Wilson
  JCO 2007 25: 4503-4504 [Full Text]

This article has been cited by other articles:

				P. M. Busse, J. R. Clark, V. V. Muse, and V. Liu Case 19-2008 -- A 63-Year-Old HIV-Positive Man with Cutaneous Merkel-Cell Carcinoma N. Engl. J. Med., June 19, 2008; 358(25): 2717 - 2723. [Full Text] [PDF]

				K. Y. Bilimoria, A. K. Stewart, J. S. Tomlinson, E. G. Gay, C. Y. Ko, M. S. Talamonti, and D. J. Bentrem Impact of Adjuvant Radiation on Survival: A Note of Caution When Using Cancer Registry Data to Evaluate Adjuvant Treatments Ann. Surg. Oncol., December 1, 2007; 14(12): 3321 - 3327. [Abstract] [Full Text] [PDF]

				D. M. Housman, R. H. Decker, and L. D. Wilson Regarding Adjuvant Radiation Therapy in Merkel Cell Carcinoma: Selection Bias and Its Affect on Overall Survival J. Clin. Oncol., October 1, 2007; 25(28): 4503 - 4504. [Full Text] [PDF]

				P. Mojica, D. Smith, and J. D.I. Ellenhorn In Reply J. Clin. Oncol., October 1, 2007; 25(28): 4504 - 4505. [Full Text] [PDF]