EARLY AGGRESSIVE TREATMENT FOR MERKEL CELL-CARCINOMA IMPROVES OUTCOME

BACKGROUND: Merkel cell carcinoma (MCC) is a rare and aggressive neuro endocrine tumor of dermal origin, Treatment recommendations are limite d owing to a paucity of retrospective data and an absence of prospecti ve data. The objective of this study was to determine current therapeu tic trends and their impact upon outcome, METHODS: A retrospective stu dy (1983 to 1996) was performed with patients from the Department of D efense and our University-affiliate hospitals, RESULTS: Thirty-five pa tients were evaluated with a mean follow-up of 31 months, Overall, 1- and 2-year survival rates were 80% and 50%, respectively, Patients und ergoing wide local excision, prophylactic lymph node dissection, and a djuvant radiotherapy had significantly decreased locoregional and dist ant recurrence rates and improved survival when compared with their co unterparts, Adjuvant chemotherapy did not diminish recurrence rates no r improve survival. Both locoregional and distant recurrence significa ntly decreased survival, CONCLUSIONS: These data suggest that early ag gressive treatment for MCC improves both tumor control and survival, w hereas the early use of chemotherapy does not improve outcome, (C) 199 7 by Excerpta Medica, Inc.