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Merkel cell carcinoma of the head and neck: Potential histopathologic predictors
Author(s) -
Haerle Stephan K.,
Shiau Carolyn,
Goldstein David P.,
Qiu Xin,
Erovic Boban M.,
Ghazarian Danny,
Xu Wei,
Irish Jonathan C.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24233
Subject(s) - merkel cell carcinoma , medicine , head and neck , carcinoma , resection margin , surgical margin , adjuvant radiotherapy , frozen section procedure , retrospective cohort study , merkel cell , margin (machine learning) , oncology , radiation therapy , surgery , resection , machine learning , computer science
Objectives/Hypothesis To identify or confirm any new or suggested independent histopathological predictors in Merkel cell carcinoma (MCC) of the head and neck (HN) correlated with outcome. Study Design Retrospective chart and pathology review. Methods Between 1990 and 2010, 58 patients with Merkel cell carcinoma of the head and neck HNMCC were identified for study. Pathologic specimens were reviewed and evaluated for independent prognostic factors and correlated with locoregional recurrence and disease‐specific survival. Results The 2‐ and 5‐year disease‐specific survival (DSS) rates were 72.7% and 63.6%, respectively. The local and regional recurrence rates were 12.0% and 24.1%, respectively. A total of 25.9% of the patients developed distant metastases during follow‐up. Tumor size (< 1 cm vs. > 1 cm) and the presence of a positive deep resection margin were independently found to be significantly associated with regional recurrence ( P = 0.01 and P = 0.04, respectively). No other prognostic factors could be identified. Conclusion Adjuvant radiotherapy cannot remediate a positive resection margin. Given these results, consideration for revision surgery should be considered for a positive deep margin. Frozen section analysis may help to define the margins in this invasive and aggressive disease. Level of Evidence 2b. Laryngoscope , 123:3043–3048, 2013