ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2016
Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2018Guideline
- General health versus tumor stage: determinants of survival in Merkel cell carcinoma assessed by sentinel lymph node biopsy.Journal of cancer research and clinical oncology · 2026Article
- Prognostic patterns in invasion lymph nodes of lung adenocarcinoma reveal distinct tumor microenvironments.NPJ precision oncology · 2024Article
- Predictors of False Negative Sentinel Lymph Node Biopsy in Clinically Localized Merkel Cell Carcinoma.Annals of surgical oncology · 2021Article
- Clinical Features and Prognosis of Merkel Cell Carcinoma in Elderly Patients.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Common traps/pitfalls and emergency diagnosis in dermatopathology.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Review
- Danger is only skin deep: aggressive epidermal carcinomas. An overview of the diagnosis, demographics, molecular-genetics, staging, prognostic biomarkers, and therapeutic advances in Merkel cell carcinoma.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Review
- The biology and treatment of Merkel cell carcinoma: current understanding and research priorities.Nature reviews. Clinical oncology · 2018Review
- Merkel Cell Carcinoma.Surgical pathology clinics · 2017Review
- Merkel Cell Carcinoma Therapeutic Update.Current treatment options in oncology · 2016Review
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Authors and funding
11 authors at 5 institutions in 2 countries.
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Abstract
Sentinel lymph node biopsy is used to stage Merkel cell carcinoma, but its prognostic value has been questioned. Furthermore, predictors of outcome in sentinel lymph node positive Merkel cell carcinoma patients are poorly defined. In breast carcinoma, isolated immunohistochemically positive tumor cells have no impact, but in melanoma they are considered significant. The significance of sentinel lymph node metastasis tumor burden (including isolated tumor cells) and pattern of involvement in Merkel cell carcinoma are unknown. In this study, 64 Merkel cell carcinomas involving sentinel lymph nodes and corresponding immunohistochemical stains were reviewed and clinicopathological predictors of outcome were sought. Five metastatic patterns were identified: (1) sheet-like (n=38, 59%); (2) non-solid parafollicular (n=4, 6%); (3) sinusoidal, (n=11, 17%); (4) perivascular hilar (n=1, 2%); and (5) rare scattered parenchymal cells (n=10, 16%). At the time of follow-up, 30/63 (48%) patients had died with 21 (33%) attributable to Merkel cell carcinoma. Patients with pattern 1 metastases had poorer overall survival compared with patients with patterns 2-5 metastases (P=0.03), with 22/30 (73%) deaths occurring in pattern 1 patients. Three (10%) deaths occurred in patients showing pattern 5, all of whom were immunosuppressed. Four (13%) deaths occurred in pattern 3 patients and 1 (3%) death occurred in a pattern 2 patient. In multivariable analysis, the number of positive sentinel lymph nodes (1 or 2 versus >2, P<0.0001), age (<70 versus ≥70, P=0.01), sentinel lymph node metastasis pattern (patterns 2-5 versus 1, P=0.02), and immune status (immunocompetent versus suppressed, P=0.03) were independent predictors of outcome, and could be used to stratify Stage III patients into three groups with markedly different outcomes. In Merkel cell carcinoma, the pattern of sentinel lymph node involvement provides important prognostic information and utilizing this data with other clinicopathological features facilitates risk stratification of Merkel cell carcinoma patients who may have management implications.
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