Merkel Cell Carcinoma: Evaluation of the Clinico-Pathological Characteristics, Treatment Strategies and Prognostic Factors in a Monocentric Retrospective Series (n=143)

Frontiers in Oncology

Luisa Piccin¹  Sara Cingarlini³  Renzo Mazzarotto⁴  Alessandro Parisi⁵  Jacopo Pigozzo⁶  Giovanni Scarzello⁶  Michele Gregianin⁷  Francesco Cavallin⁸  Mauro Alaibac⁹  Claudia Di Prata^1,10  Daniele Bertin^1,10  Franco Bassetto^1,10  Saveria Tropea^1,10  Antonella Vecchiato^1,12  Marco Rastrelli^1,12  Alessandro Dal Monico^1,13  Jacopo Tartaglia^1,13  Irene Russo^1,13  Vanna Chiarion-Sileni^1,13  Alessio Fabozzi^1,14  Tito Brambullo^1,14  Bernardo Biffoli^1,15  Rocco Cappellesso^1,16  Angelo Paolo Dei Tos^1,16  Elisabetta Bezzon^1,17  Paolo Del Fiore^1,17  Luigi Dall’Olmo^1,17  Romina Spina^1,17  Vincenzo Vindigni^1,17  Simone Mocellin^1,17  Beatrice Ferrazzi^1,17  Francesco Russano^1,17  Lorenzo Nicolè^1,18 

[1] Cytopathology, Ospedale dell’Angelo, Mestre, Italy;0Postgraduate School of Occupational Medicine, University of Verona, Verona, Italy;1Radiology Unit, Department of Imaging and Medical Physics, Istituto Oncologico Veneto (IOV) IRCSS, Padua, Italy;2Oncology Section, Department of Oncology, Verona University and Hospital Trust, Verona, Italy;3Department of Radiotherapy, Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy;4Radiotherapy Unit, Veneto Institute of Oncology, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy;5Radiotherapy and Nuclear Medicine Unit, Oncological Institute of Veneto IOV-IRCCS, Padua, Italy;6Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy;7Independent Statistician, Solagna, Italy;Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, University of Padua, Padua, Italy;Department of Medicine, University of Padua School of Medicine and Surgery, Padua, Italy;Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy;Division of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy;Melanoma Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy;Oncology Unit 3, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy;Pathological Anatomy Unit, University Hospital of Padua, Padua, Italy;Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy;;Unit of Surgical Pathology &

关键词: Merkel cell cancer;    Merkel carcinoma;    Merkel treatment strategies;    non-melanoma skin cancer (NMSC);    skin cancer;   

DOI  :  10.3389/fonc.2021.737842

来源: DOAJ

【 摘 要 】

BackgroundMerkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. The incidence of the disease has undergone a significant increase in recent years, which is caused by an increase in the average age of the population and in the use of immunosuppressive therapies. MCC is an aggressive pathology, which metastasizes early to the lymph nodes. These characteristics impose an accurate diagnostic analysis of the regional lymph node district with radiography, clinical examination and sentinel node biopsy. In recent years, there has been a breakthrough in the treatment of the advanced pathology thanks to the introduction of monoclonal antibodies acting on the PD-1/PD-L1 axis. This study aimed to describe the clinico-pathological characteristics, treatment strategies and prognostic factors of MCC.MethodsA retrospective cohort study was conducted involving 143 consecutive patients who were diagnosed and/or treated for MCC. These patients were referred to the Veneto Institute of Oncology IOV-IRCCS and to the University Hospital of Padua (a third-level center) in the period between December 1991 and January 2020. In the majority of cases, diagnosis took place at the IOV. However, some patients were diagnosed elsewhere and subsequently referred to the IOV for a review of the diagnosis or to begin specific therapeutic regimens.Results143 patients, with an average age of 71 years, were affected mainly with autoimmune and neoplastic comorbidities. Our analysis has shown that age, autoimmune comorbidities and the use of therapy with immunomodulating drugs (which include corticosteroids, statins and beta-blockers) are associated with a negative prognosis. In this sense, male sex is also a negative prognostic factor.ConclusionsAutoimmune and neoplastic comorbidities were frequent in the studied population. The use of drugs with immunomodulatory effects was also found to be a common feature of the population under examination. The use of this type of medication is considered a negative prognostic factor. The relevance of a multidisciplinary approach to the patient with MCC is confirmed, with the aim of assessing the risks and benefits related to the use of immunomodulating therapy in the individual patient.

【 授权许可】

Unknown