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Radiation, Surgery Improve Merkel Cancer Recurrence

Sentinel node biopsy can be useful in detecting disease spread

TUESDAY, June 20 (HealthDay News) -- Treatment of Merkel cell carcinoma with radiation in addition to surgery can improve recurrence rates, and biopsy of the sentinel lymph nodes can be useful in detecting the spread of the disease, according to a pair of reports in the June issue of the Archives of Dermatology.

Clark C. Otley, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues reviewed 333 published reports regarding outcomes after treatment of Merkel cell carcinoma with radiation plus surgery, or with surgery alone. The researchers found significantly lower rates of local and regional recurrence with surgery plus local adjuvant radiation.

Paul Nghiem, M.D., Ph.D., of the Seattle Cancer Care Alliance in Washington, and colleagues examined the usefulness of sentinel lymph node biopsy and computed tomography scans in 61 patients with Merkel cell carcinoma (of whom 30 had undergone a biopsy) and 92 published cases of patients with Merkel cell carcinoma who had undergone a biopsy. A sentinel node biopsy detected the spread of cancer in about one-third of cases that would have otherwise been understaged. The study was partially funded by the Shiseido Corporation.

The studies "do not change the fact that Merkel cell carcinoma should first and foremost be removed surgically," states an accompanying editorial. "If sentinel lymph node biopsy is performed, definitive excision should be delayed until after such biopsy."

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